Cost-effectiveness of a multifactorial fall prevention program in nursing homes

TY - JOUR

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 -