Cost-effectiveness of a day hospital falls prevention programme for screened community-dwelling older people at high risk of falls
Cost-effectiveness of a day hospital falls prevention programme for screened community-dwelling older people at high risk of falls
Background: multifactorial falls prevention programmes for older people have been proved to reduce falls. However, evidence of their cost-effectiveness is mixed.
Design: economic evaluation alongside pragmatic randomised controlled trial.
Intervention: randomised trial of 364 people aged ≥70, living in the community, recruited via GP and identified as high risk of falling. Both arms received a falls prevention information leaflet. The intervention arm were also offered a (day hospital) multidisciplinary falls prevention programme, including physiotherapy, occupational therapy, nurse, medical review and referral to other specialists.
MEASUREMENTS: self-reported falls, as collected in 12 monthly diaries. Levels of health resource use associated with the falls prevention programme, screening (both attributed to intervention arm only) and other health-care contacts were monitored. Mean NHS costs and falls per person per year were estimated for both arms, along with the incremental cost-effectiveness ratio (ICER) and cost effectiveness acceptability curve.
Results: in the base-case analysis, the mean falls programme cost was £349 per person. This, coupled with higher screening and other health-care costs, resulted in a mean incremental cost of £578 for the intervention arm. The mean falls rate was lower in the intervention arm (2.07 per person/year), compared with the control arm (2.24). The estimated ICER was £3,320 per fall averted.
Conclusions: the estimated ICER was £3,320 per fall averted. Future research should focus on adherence to the intervention and an assessment of impact on quality of life.
accidental falls/prevention & control, aged, cost-benefit analysis, day care, medical/economics, geriatric assessment/methods, health services/economics, hospital costs/statistics & numerical data, housing for the elderly/statistics & numerical data, humans, mass screening/methods, occupational therapy/economics, patient care team/economics, physical therapy modalities/economics, program evaluation, residence characteristics/statistics & numerical data, risk factors
710-716
Irvine, Lisa
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Conroy, Simon P.
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Sach, Tracey
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Gladman, John R.F.
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Harwood, Rowan H.
ecf3a13f-9699-44ec-98db-0db3f26ae1ed
Kendrick, Denise
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Coupland, Carol
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Drummond, Avril
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Barton, Garry
d46579ef-f0f4-4650-badc-8f9fd10eeb01
Masud, Tahir
ef1fc17c-f133-4635-82bb-547b58521ceb
Irvine, Lisa
3180e023-ae18-41fb-980b-e299973e5e77
Conroy, Simon P.
328b2043-4486-442a-916b-072db683822e
Sach, Tracey
5c09256f-ebed-4d14-853a-181f6c92d6f2
Gladman, John R.F.
89788999-01d4-4bd1-adb0-d96b68f2f270
Harwood, Rowan H.
ecf3a13f-9699-44ec-98db-0db3f26ae1ed
Kendrick, Denise
33ad9db9-6d98-4e87-a2ad-323b289e3a16
Coupland, Carol
5d123e7a-f406-4d6b-a09d-2e019de3686f
Drummond, Avril
559a0644-290a-4fcf-9781-0174f2553a8d
Barton, Garry
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Masud, Tahir
ef1fc17c-f133-4635-82bb-547b58521ceb
Irvine, Lisa, Conroy, Simon P., Sach, Tracey, Gladman, John R.F., Harwood, Rowan H., Kendrick, Denise, Coupland, Carol, Drummond, Avril, Barton, Garry and Masud, Tahir
(2010)
Cost-effectiveness of a day hospital falls prevention programme for screened community-dwelling older people at high risk of falls.
Age and Ageing, 39 (6), .
(doi:10.1093/ageing/afq108).
Abstract
Background: multifactorial falls prevention programmes for older people have been proved to reduce falls. However, evidence of their cost-effectiveness is mixed.
Design: economic evaluation alongside pragmatic randomised controlled trial.
Intervention: randomised trial of 364 people aged ≥70, living in the community, recruited via GP and identified as high risk of falling. Both arms received a falls prevention information leaflet. The intervention arm were also offered a (day hospital) multidisciplinary falls prevention programme, including physiotherapy, occupational therapy, nurse, medical review and referral to other specialists.
MEASUREMENTS: self-reported falls, as collected in 12 monthly diaries. Levels of health resource use associated with the falls prevention programme, screening (both attributed to intervention arm only) and other health-care contacts were monitored. Mean NHS costs and falls per person per year were estimated for both arms, along with the incremental cost-effectiveness ratio (ICER) and cost effectiveness acceptability curve.
Results: in the base-case analysis, the mean falls programme cost was £349 per person. This, coupled with higher screening and other health-care costs, resulted in a mean incremental cost of £578 for the intervention arm. The mean falls rate was lower in the intervention arm (2.07 per person/year), compared with the control arm (2.24). The estimated ICER was £3,320 per fall averted.
Conclusions: the estimated ICER was £3,320 per fall averted. Future research should focus on adherence to the intervention and an assessment of impact on quality of life.
Text
afq108
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More information
Accepted/In Press date: 20 July 2010
e-pub ahead of print date: 10 September 2010
Keywords:
accidental falls/prevention & control, aged, cost-benefit analysis, day care, medical/economics, geriatric assessment/methods, health services/economics, hospital costs/statistics & numerical data, housing for the elderly/statistics & numerical data, humans, mass screening/methods, occupational therapy/economics, patient care team/economics, physical therapy modalities/economics, program evaluation, residence characteristics/statistics & numerical data, risk factors
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Local EPrints ID: 478153
URI: http://eprints.soton.ac.uk/id/eprint/478153
ISSN: 0002-0729
PURE UUID: d20f61bc-3a21-437c-a436-5bf1b413bbbd
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Date deposited: 22 Jun 2023 16:50
Last modified: 17 Mar 2024 04:19
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Contributors
Author:
Lisa Irvine
Author:
Simon P. Conroy
Author:
Tracey Sach
Author:
John R.F. Gladman
Author:
Rowan H. Harwood
Author:
Denise Kendrick
Author:
Carol Coupland
Author:
Avril Drummond
Author:
Garry Barton
Author:
Tahir Masud
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