Proefschrift

PWB insurgically treated trauma patients with peri- and/or intra-articular fractures of the lower extremities is cost effective 111 Costs Volumes of cost items during the 3-month pre-trauma period were low and comparable between the groups (Table 8.3). From the total population 77.4% of the patients (N=82) reached full weight bearing within 12 weeks. The number of patients who reached full weight bearing within 12 weeks was significantly higher in the PWB group than in the RWB group: 98.1% versus 56.6% (p<0.01). The median time from surgery to ascertainment of full weight bearing was significantly shorter in the PWB group than in the RWB group: 4.0 (2.1) weeks versus 12.2 (4.2) weeks (p<0.01). Furthermore, the total outpatient physiotherapy duration in the PWB was significantly lesser compared to the RWB group. The incidence of postoperative complications of the total study population was 16.0%. No significant differences between the PWB group and the RWB group were found regarding the incidence of postoperative complications (11.3% (N=6) versus 20.8% (N=11), respectively (p=0.19). Results from rehabilitation outcome measures and post-operative complications in patients in the PWB and RWB group are summarized in Table 8.4. After a follow-up of 26 weeks post-surgery, the total mean costs per patient were €457.51 lower in the PWB group than in the RWB group (see Table 8.3). The cost of production losses due to absence from work was €1,440.92 lower in the PWB group compared to the RWB group. Cost-effectiveness analysis For both the base case as the sensitivity analysis the PWB can be considered costeffective with a cost saving per gained score on the LEFS for the base case and slight costs per gained point for the sensitivity analysis scenarios. Cost-effectiveness based on QALYs for the base case can be considered because the incremental value is below the set threshold of €50,000 (see Table 8.5). Based on this threshold, the probability that the PWB protocol is cost-effective at 26 weeks post-surgery is 66%, from a societal perspective (Figure 2). The sensitivity analysis scenarios, based on the work status and the SF-12 questionnaire, are above the threshold of €50,000 or inferior to the CAU (see Table 8.5).

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