Abstract
BACKGROUND: A Distal radius fracture (DRF) is a common upper extremity injury with a significant socioeconomic burden. While various treatments exist, comprehensive health economic evaluations comparing Traditional Chinese Medicine (TCM), Western medicine (WM), and integrated Chinese-Western medicine (ICWM) treatment for DRF using real-world data are lacking. This study aims to conduct a cost-effectiveness analysis (CEA) of these three treatment strategies to guide clinical decisions and resource allocation. METHODS: A retrospective analysis was conducted using 2023 data from the Beijing Medical Price Platform. DRF inpatients were categorized into TCM, WM, and ICWM groups based on procedure codes. Propensity Score Matching (PSM) was employed to balance demographic and clinical confounders. The primary outcomes included the improvement rate of the Barthel Index (reflecting activities of daily living) and the average hospitalization cost. CEA was performed by calculating the cost-effectiveness ratio (CER) and the incremental cost-effectiveness ratio (ICER). RESULTS: After PSM, the improvement rates for the WM versus TCM groups were 23.74% and 24.93%, with average costs of CNY 39,022.99 and CNY 6,369.00, respectively. For WM versus ICWM, the rates were 19.53% and 18.63%, with costs of CNY 33,462.91 and CNY 26,130.69, respectively. There was no significant difference in improvement rates among the groups. The TCM group demonstrated a significantly lower CER (255.48 CNY per percentage point) compared to the WM (1,643.87 CNY per percentage point) and ICWM (1,402.62 CNY per percentage point) groups. The ICER indicated that TCM was dominant (lower cost, better effect) compared to WM (ICER: -27,426.06 CNY per percentage point). Probabilistic sensitivity analysis (PSA) via 1,000 Monte Carlo simulations confirmed the robustness of results, with TCM and ICWM showing 80% and 55% probabilities of being cost-effective, respectively, across varying willingness-to-pay (WTP) thresholds. CONCLUSION: TCM conservative treatment for DRF offers a clear cost advantage over WM and ICWM treatment, with similar effectiveness, highlighting its potential for “simplicity, convenience, validity, and low cost.” Although ICWM is less expensive than WM alone, it shows suboptimal resource integration. It is advisable to adopt a tiered “TCM main, Western auxiliary” diagnosis and treatment model to effectively reduce the financial burden on patients and the healthcare system.