Disaggregated unit cost Number of units of resource per Setting in Proportion relevant Provider of which of patients Other Private time Safety Total resource resource is receiving MBS govt health Patient horizon per nets* cost provided resource budget insurer patient receiving resource Hand Rehabilitation ‐ therapist Specialist Removal of the ‐ fracture fixation Revision surgery ‐ E.g. MBS 47930, ‐ 47927 or 47924 Clinical input and information from the assessment phase will be required to confirm the proportion of units for the current and proposed procedures. Other potentially relevant healthcare resources related to fracture repair such as day theatre usage, attending nursing staff, potential follow-up procedures (plaster casts, analgesics) will be common across paired procedures. Proposed structure of economic evaluation (decision-analytic) Due to the wide proposed changes to both new and existing items, there are three PICO tables to account for all interventions and populations of interest (Table 7 to Table 9). Due to the difficulties in accurately defining, both clinically and for the purposes of the review, the specific intervention and comparator these will be kept broad. There are three clinical procedures as interventions: Cast immobilisation (no reduction) Closed reduction, cast immobilisation Open reduction, cast immobilisation There are three clinical comparator procedures: Cast immobilisation (no reduction) Closed reduction, cast immobilisation Open reduction, cast immobilisation Table 7: Suggested summary of extended PICO to define research question that assessment will investigate: cast immobilisation of fracture of the wrist Patients Intervention Comparator Outcomes to be Healthcare resources assessed to be considered Patients with a fracture Cast immobilisation Any other intervention. Primary outcomes: The healthcare of the wrist (this could be NB there is likely to be Patient functional resources are similar in Subgroups: Fracture undertaken by a GP or no comparator for this assessment (including both current and future of the distal radius or by a specialist, possibly population. quality of life) situations. ulna not involving the after a CT scan) Grip strength joint Range of movement
Provider of resource Setting in which resource is provided Proportion of patients receiving resource Number of units of resource per relevant time horizon per patient receiving resource Disaggregated unit cost MBS Safety nets* Other govt budget Private health insurer Patient Total cost ‐ Rehabilitation Hand therapist ‐ Removal of the fracture fixation Specialist ‐ Revision surgery ‐ E.g. MBS 47930, 47927 or 47924 Clinical input and information from the assessment phase will be required to confirm the proportion of units for the current and proposed procedures. Other potentially relevant healthcare resources related to fracture repair such as day theatre usage, attending nursing staff, potential follow-up procedures (plaster casts, analgesics) will be common across paired procedures. Proposed structure of economic evaluation (decision-analytic) Due to the wide proposed changes to both new and existing items, there are three PICO tables to account for all interventions and populations of interest (Table 7 to Table 9). Due to the difficulties in accurately defining, both clinically and for the purposes of the review, the specific intervention and comparator these will be kept broad. There are three clinical procedures as interventions: Cast immobilisation (no reduction) Closed reduction, cast immobilisation Open reduction, cast immobilisation There are three clinical comparator procedures: Cast immobilisation (no reduction) Closed reduction, cast immobilisation Open reduction, cast immobilisation Table 7: Suggested summary of extended PICO to define research question that assessment will investigate: cast immobilisation of fracture of the wrist Patients Intervention Comparator Outcomes to be assessed Healthcare resources to be considered Patients with a fracture of the wrist Subgroups: Fracture of the distal radius or ulna not involving the joint Cast immobilisation (this could be undertaken by a GP or by a specialist, possibly after a CT scan) Any other intervention. NB there is likely to be no comparator for this population. Primary outcomes: Patient functional assessment (including quality of life) Grip strength Range of movement The healthcare resources are similar in both current and future situations.
1205a-wrist-FinalDAP-Accessible.docx