Cost-effectiveness of a multifactorial fall prevention program in nursing homes
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Cost-effectiveness of a multifactorial fall prevention program in nursing homes. / Heinrich, S; Rapp, K; Stuhldreher, N; Rissmann, U; Becker, C; König, H-H.
in: OSTEOPOROSIS INT, Jahrgang 24, Nr. 4, 01.04.2013, S. 1215-23.Publikationen: SCORING: Beitrag in Fachzeitschrift/Zeitung › SCORING: Zeitschriftenaufsatz › Forschung › Begutachtung
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T1 - Cost-effectiveness of a multifactorial fall prevention program in nursing homes
AU - Heinrich, S
AU - Rapp, K
AU - Stuhldreher, N
AU - Rissmann, U
AU - Becker, C
AU - König, H-H
PY - 2013/4/1
Y1 - 2013/4/1
N2 - UNLABELLED: The purpose of this study was to analyze the cost-effectiveness of a multifactorial fall prevention program in nursing home residents. Given a willingness-to-pay (WTP) of 50,000 EUR per year free of femoral fracture, the probability that the intervention is cost-effective is 83%.INTRODUCTION: Despite their increased risk of falls and fractures, nursing home residents have been neglected in economic evaluations of fall prevention programs so far. The purpose of this study was to analyze, for the first time, the cost-effectiveness of a multifactorial fall prevention program in nursing home residents.METHODS: This study is part of a prospective, unblinded, cluster, nonrandomized, controlled study focusing on the transfer of an efficacious fall prevention program into a real-world setting. The analyzed subsample was derived from claims data and consisted of data on intervention (n=256, residents n=10,178) and control homes (n=893, residents n=22,974), representing all insurants of a sickness fund (AOK Bavaria, Germany) who were 65 years or older, residing in a nursing home on the 31st of March 2007 and had a level of care of ≥1 according to the classification of the statutory long-term care insurance. Time free of femoral fracture (ICD-10, S72) was used as measure of health effects. Femoral fracture-related costs and intervention costs were measured from a payer perspective. Multivariate regression models were applied. Sensitivity analyses were performed and cost-effectiveness acceptability curves computed.RESULTS: Within the first year of the intervention, femoral fracture rate was significantly reduced, resulting in a nonsignificant incremental mean time of 1.41 days free of femoral fracture. Incremental mean total direct costs were 29 EUR per resident, which was not significant. The incremental cost-effectiveness ratio (ICER) was 7,481 EUR per year free of femoral fracture. The probability of an ICER<50,000 EUR per year free of femoral fracture was 83%.CONCLUSION: Depending on the amount the decision-maker is willing to pay for the incremental effect, the fall prevention program might be cost-effective within the first year. Future studies should expand the range of costs and effects measured.
AB - UNLABELLED: The purpose of this study was to analyze the cost-effectiveness of a multifactorial fall prevention program in nursing home residents. Given a willingness-to-pay (WTP) of 50,000 EUR per year free of femoral fracture, the probability that the intervention is cost-effective is 83%.INTRODUCTION: Despite their increased risk of falls and fractures, nursing home residents have been neglected in economic evaluations of fall prevention programs so far. The purpose of this study was to analyze, for the first time, the cost-effectiveness of a multifactorial fall prevention program in nursing home residents.METHODS: This study is part of a prospective, unblinded, cluster, nonrandomized, controlled study focusing on the transfer of an efficacious fall prevention program into a real-world setting. The analyzed subsample was derived from claims data and consisted of data on intervention (n=256, residents n=10,178) and control homes (n=893, residents n=22,974), representing all insurants of a sickness fund (AOK Bavaria, Germany) who were 65 years or older, residing in a nursing home on the 31st of March 2007 and had a level of care of ≥1 according to the classification of the statutory long-term care insurance. Time free of femoral fracture (ICD-10, S72) was used as measure of health effects. Femoral fracture-related costs and intervention costs were measured from a payer perspective. Multivariate regression models were applied. Sensitivity analyses were performed and cost-effectiveness acceptability curves computed.RESULTS: Within the first year of the intervention, femoral fracture rate was significantly reduced, resulting in a nonsignificant incremental mean time of 1.41 days free of femoral fracture. Incremental mean total direct costs were 29 EUR per resident, which was not significant. The incremental cost-effectiveness ratio (ICER) was 7,481 EUR per year free of femoral fracture. The probability of an ICER<50,000 EUR per year free of femoral fracture was 83%.CONCLUSION: Depending on the amount the decision-maker is willing to pay for the incremental effect, the fall prevention program might be cost-effective within the first year. Future studies should expand the range of costs and effects measured.
KW - Accidental Falls
KW - Aged
KW - Aged, 80 and over
KW - Cost-Benefit Analysis
KW - Female
KW - Femoral Fractures
KW - Germany
KW - Health Care Costs
KW - Health Promotion
KW - Homes for the Aged
KW - Humans
KW - Male
KW - Nursing Homes
KW - Program Evaluation
KW - Prospective Studies
KW - Sensitivity and Specificity
U2 - 10.1007/s00198-012-2075-x
DO - 10.1007/s00198-012-2075-x
M3 - SCORING: Journal article
C2 - 22806557
VL - 24
SP - 1215
EP - 1223
JO - OSTEOPOROSIS INT
JF - OSTEOPOROSIS INT
SN - 0937-941X
IS - 4
ER -