10.25905/13299035
Hossein Haji Ali Afzali
Hossein Haji Ali
Afzali
Jonathan Karnon
Jonathan
Karnon
University of Adelaide
Olga Theou
Olga
Theou
University of Adelaide
Justin Beilby
Justin
Beilby
Torrens University Australia
Matteo Cesari
Matteo
Cesari
Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico
University of Milan
Renuka Visvanathan
Renuka
Visvanathan
University of Adelaide
Structuring a conceptual model for cost effectiveness analysis of frailty interventions
Background Frailty is a major health issue which impacts the life of older people, posing a significant challenge to the health system. One of the key emerging areas is the development of frailty interventions to halt or reverse the progression of the condition. In many countries, economic evidence is required to inform public funding decisions for such interventions, and cost-effectiveness models are needed to estimate long-term costs and effects. Such models should capture current clinical understanding of frailty, its progression and its health consequences. The objective of this paper is to present a conceptual model of frailty that can be used to inform the development of a cost-effectiveness model to evaluate frailty interventions. Methods After critical analysis of the clinical and economic literature, a Delphi study consisting of experts from the disciplines of clinical medicine and epidemiology was undertaken to inform the key components of the conceptual model. We also identified relevant databases that can be used to populate and validate the model. Results A list of significant health states/events for which frailty is a strong independent risk factor was identified (e.g., hip fracture, hospital admission, delirium, death). We also identified a list of important patient attributes that may influence disease progression (e.g., age, gender, previous hospital admissions, depression). A number of large-scale relevant databases were also identified to populate and validate the cost-effectiveness model. Face validity of model structure was confirmed by experts. Discussion and conclusions The proposed conceptual model is being used as a basis for developing a new cost-effectiveness model to estimate lifetime costs and outcomes associated with a range of frailty interventions. Using an appropriate model structure, which more accurately reflects the natural history of frailty, will improve model transparency and accuracy. This will ultimately lead to better informed public funding decisions around interventions to manage frailty.
Public health not elsewhere classified
Aged health care
Torrens University Australia
2022
2022-11-03
2022-11-03
Journal contribution
0 Bytes
10.1371/journal.pone.0222049
CC BY 4.0