The Cost-effectiveness of Early Physical Medicine Rehabilitation (PM) Consultation for Trauma Patients in a Level 1 Trauma Centre in Canada
Bibliographic record
Abstract
BACKGROUND: Physical Medicine Rehabilitation (PM) consultation at Level 1 trauma centres improves clinical outcomes in major trauma patients. Cost-effectiveness evaluation of this intervention is lacking, but important for healthcare payers. PURPOSE: Assess incremental cost for providing PM consultation, per quality adjusted life year (QALY), from single public health payer perspective. METHODS: Probabilistic Markov model incorporating clinical trial data, administrative data and published literature to estimate incremental cost and effect over a life-time horizon. RESULTS: For major trauma sustained at age 18, incremental cost of providing PM consultation was $5,297. Incremental effect was 0.18 QALY. The incremental cost effectiveness ratio (ICER) was $29,428/QALY. Incremental effect increases with increased age, decreasing the ICER to $16,150/QALY for trauma sustained at age 75. CONCLUSIONS: PM consultation is associated with increased cost and increased QALY. Across all age groups, the ICER falls below a $50,000/QALY threshold, indicating PM consultation is likely a cost-effective intervention.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.009 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.005 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".