Title |
Economic evaluation of a group-based exercise program for falls prevention among the older community-dwelling population
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Published in |
BMC Geriatrics, March 2015
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DOI | 10.1186/s12877-015-0028-x |
Pubmed ID | |
Authors |
Kendra McLean, Lesley Day, Andrew Dalton |
Abstract |
Falls among older people are of growing concern globally. Implementing cost-effective strategies for their prevention is of utmost importance given the ageing population and associated potential for increased costs of fall-related injury over the next decades. The purpose of this study was to undertake a cost-utility analysis and secondary cost-effectiveness analysis from a healthcare system perspective, of a group-based exercise program compared to routine care for falls prevention in an older community-dwelling population. A decision analysis using a decision tree model was based on the results of a previously published randomised controlled trial with a community-dwelling population aged over 70. Measures of falls, fall-related injuries and resource use were directly obtained from trial data and supplemented by literature-based utility measures. A sub-group analysis was performed of women only. Cost estimates are reported in 2010 British Pound Sterling (GBP). The ICER of GBP£51,483 per QALY for the base case analysis was well above the accepted cost-effectiveness threshold of GBP£20,000 to £30,000 per QALY, but in a sensitivity analysis with minimised program implementation costs reached GBP£25,678 per QALY. The ICER value at 95% confidence in the base case analysis was GBP£99,664 per QALY and GBP£50,549 per QALY in the lower cost analysis. Males had a 44% lower injury rate if they fell, compared to females resulting in a more favourable ICER for the women only analysis. For women only the ICER was GBP£22,986 per QALY in the base case and was below the cost-effectiveness threshold for all other variations of program implementation. The ICER value at 95% confidence was GBP£48,212 in the women only base case analysis and GBP£23,645 in the lower cost analysis. The base case incremental cost per fall averted was GBP£652 (GBP£616 for women only). A threshold analysis indicates that this exercise program cannot realistically break even. The results suggest that this exercise program is cost-effective for women only. There is no evidence to support its cost-effectiveness in a group of mixed gender unless the costs of program implementation are minimal. Conservative assumptions may have underestimated the true cost-effectiveness of the program. |
Mendeley readers
Geographical breakdown
Country | Count | As % |
---|---|---|
United Kingdom | 2 | 2% |
Canada | 1 | <1% |
Unknown | 98 | 97% |
Demographic breakdown
Readers by professional status | Count | As % |
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Student > Master | 27 | 27% |
Researcher | 15 | 15% |
Student > Bachelor | 14 | 14% |
Student > Ph. D. Student | 10 | 10% |
Student > Doctoral Student | 5 | 5% |
Other | 11 | 11% |
Unknown | 19 | 19% |
Readers by discipline | Count | As % |
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Nursing and Health Professions | 20 | 20% |
Medicine and Dentistry | 20 | 20% |
Sports and Recreations | 7 | 7% |
Social Sciences | 5 | 5% |
Engineering | 5 | 5% |
Other | 20 | 20% |
Unknown | 24 | 24% |