{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,8]],"date-time":"2025-11-08T13:06:13Z","timestamp":1762607173815,"version":"3.37.3"},"reference-count":33,"publisher":"Oxford University Press (OUP)","issue":"2","license":[{"start":{"date-parts":[[2018,3,9]],"date-time":"2018-03-09T00:00:00Z","timestamp":1520553600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2019,6,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>The study evaluated the cost-effectiveness of hydrotherapy versus land-based therapy in patients with musculoskeletal disorders (MSDs) in Singapore.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A decision-analytic model was constructed to compare the cost-effectiveness of hydrotherapy to land-based therapy over 3 months from societal perspective. Target population comprised patients with low back pain (LBP), osteoarthritis (OA), rheumatoid arthritis (RA), total hip replacement (THR) and total knee replacement (TKR). Subgroup analyses were carried out to determine the cost-effectiveness of hydrotherapy in individual MSDs. Relative treatment effects were obtained through a systematic review of published data.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Compared to land-based therapy, hydrotherapy was associated with an incremental cost-effectiveness ratio (ICER) of SGD 27 471 per quality-adjusted life-year (QALY) gained, which was below the willingness-to-pay threshold of SGD 70 000 per QALY (one gross domestic product per capita in Singapore in 2015). For the respective MSDs, hydrotherapy were dominant (more effective and less costly) in THR and TKR, cost-effective for LBP and RA, and not cost-effective for OA. Treatment adherence and cost of hydrotherapy were key drivers to the ICER values.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Hydrotherapy was a cost-effective rehabilitation compared to land-based therapy for a population with MSDs in Singapore. However, the benefit of hydrotherapy was not observed in patients with OA.<\/jats:p><\/jats:sec>","DOI":"10.1093\/pubmed\/fdy044","type":"journal-article","created":{"date-parts":[[2018,2,14]],"date-time":"2018-02-14T12:09:56Z","timestamp":1518610196000},"page":"391-398","source":"Crossref","is-referenced-by-count":10,"title":["Cost-effectiveness of hydrotherapy versus land-based therapy in patients with musculoskeletal disorders in Singapore"],"prefix":"10.1093","volume":"41","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4901-2649","authenticated-orcid":false,"given":"Monica","family":"Teng","sequence":"first","affiliation":[{"name":"Pharmacy and Therapeutics Office, Group Health Informatics, National Healthcare Group, 3 Fusionopolis Link, #03-08 Nexus@one-north, Singapore, Singapore"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hui Jun","family":"Zhou","sequence":"additional","affiliation":[{"name":"Pharmacy and Therapeutics Office, Group Health Informatics, National Healthcare Group, 3 Fusionopolis Link, #03-08 Nexus@one-north, Singapore, Singapore"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Liang","family":"Lin","sequence":"additional","affiliation":[{"name":"Pharmacy and Therapeutics Office, Group Health Informatics, National Healthcare Group, 3 Fusionopolis Link, #03-08 Nexus@one-north, Singapore, Singapore"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pang Hung","family":"Lim","sequence":"additional","affiliation":[{"name":"Rehabilitation Centre Allied Health Services, Tan Tock Seng Hospital, Singapore"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Doreen","family":"Yeo","sequence":"additional","affiliation":[{"name":"Rehabilitation Centre Allied Health Services, Tan Tock Seng Hospital, Singapore"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Suzanne","family":"Goh","sequence":"additional","affiliation":[{"name":"Allied Health Services and Pharmacy Operations Division, Tan Tock Seng Hospital, Singapore"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Soon Yin","family":"Tjan","sequence":"additional","affiliation":[{"name":"Department of Rehabilitation Medicine, Tan Tock Seng Hospital, Singapore"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Boon Peng","family":"Lim","sequence":"additional","affiliation":[{"name":"Pharmacy and Therapeutics Office, Group Health Informatics, National Healthcare Group, 3 Fusionopolis Link, #03-08 Nexus@one-north, Singapore, Singapore"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2018,3,9]]},"reference":[{"author":"The Burden of Musculoskeletal Diseases in the United States","key":"2019071712161161800_fdy044C1"},{"key":"2019071712161161800_fdy044C2","doi-asserted-by":"crossref","first-page":"356","DOI":"10.1016\/j.berh.2015.08.002","article-title":"Economic impact of musculoskeletal disorders (MSDs) on work in Europe","volume":"29","author":"Bevan","year":"2015","journal-title":"Best Pract Res Clin Rheumatol"},{"key":"2019071712161161800_fdy044C3","doi-asserted-by":"crossref","first-page":"1211","DOI":"10.1016\/S0140-6736(17)32154-2","article-title":"Global, regional, and national incidence, prevalence, and years lived with disability for 328 diseases and injuries for 195 countries, 1990-2016: a systematic analysis for the Global Burden of Disease Study 2016","volume":"390","author":"G. 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