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Updated: Aug 1, 2026
Orthopedic Robot-Assisted Femoral Neck System in the Treatment of Femoral Neck Fracture
Published on: March 3, 2023
Cost-utility analysis of coordinator services (FLS) in patients with femur fractures
Gyeong-Min Lee1, Han-Sol Jang2, Minsu Choi2
1Institute for Health & Medical Policy, Dankook University, Cheonan, Chungcheongnam-do, Republic of Korea.
Abstract:
This study evaluated the cost-effectiveness of a care coordination program for hip fracture patients in Korea. The results show the program improves outcomes at a reasonable cost. These findings provide strong evidence to support national adoption of preventive care models for aging populations.
Background:
Femur fractures in elderly patients are associated with high mortality rates and significant healthcare costs. Fracture Liaison Services (FLS) have emerged as a systematic approach to prevent secondary fractures, but their economic evaluation in the Korean healthcare context remains limited.
Objective:
This study aimed to evaluate the cost-utility of implementing FLS coordinator services for patients with femur fractures in Korea.
Methods:
A Markov model-based cost-utility analysis was conducted using National Health Insurance Service claims data (2013-2021) and patient survey data from Eulji University Hospital. The target population included patients aged 50 years and older with femur fractures. The analysis adopted a Limited societal perspective with a Lifetime horizon, 6-month cycle length, meaning that both direct medical costs and selected non-medical costs (e.g., caregiver and transportation expenses) were considered over the patients' remaining Lifetime, with health states updated every 6 months in the model. A 4.5% annual discount rate was applied to both costs and quality-adjusted life years (QALYs).
Results:
The incremental cost-effectiveness ratio (ICER) of FLS implementation was 12,057,427 KRW per QALY gained, which is below Korea's willingness-to-pay threshold of 40 million KRW per QALY. Probabilistic sensitivity analysis showed a 92.2% probability of cost-effectiveness at the 40 million KRW threshold. The FLS program demonstrated a 41% reduction in refracture risk and a 20% reduction in mortality risk.
Conclusions:
FLS coordinator services for femur fracture patients are cost-effective in the Korean healthcare system and should be considered for implementation to improve patient outcomes while managing healthcare expenditures efficiently.
