Cost-effectiveness analysis of a multifactorial fall prevention intervention in older home care clients at risk for falling

被引:14
作者
Isaranuwatchai, Wanrudee [1 ,2 ]
Perdrizet, Johnna [1 ]
Markle-Reid, Maureen [3 ]
Hoch, Jeffrey S. [1 ,2 ,4 ]
机构
[1] St Michaels Hosp, Li Ka Shing Knowledge Inst, Ctr Excellence Econ Anal Res, 30 Bond St, Toronto, ON M5B 1W8, Canada
[2] Univ Toronto, Inst Hlth Policy Management & Evaluat, 155 Coll St, Toronto, ON M5T 3M6, Canada
[3] McMaster Univ, Sch Nursing Clin Epidemiol & Biostatist, 1200 Main St W, Hamilton, ON L8N 3Z5, Canada
[4] Univ Calif Davis, Dept Publ Hlth Sci, Div Hlth Policy & Management, 2103 Stockton Blvd, Sacramento, CA 95817 USA
关键词
Cost-effectiveness analysis; Fall prevention; Age; Older adults; Multifactorial intervention; EFFECTIVENESS ACCEPTABILITY CURVES; ECONOMIC EVALUATIONS; EXERCISE PROGRAM; CONTROLLED-TRIAL; PEOPLE; STRATEGIES; FRAMEWORK; ADULT;
D O I
10.1186/s12877-017-0599-9
中图分类号
R592 [老年病学]; C [社会科学总论];
学科分类号
03 ; 0303 ; 100203 ;
摘要
Background: Falls among older adults can cause serious morbidity and pose economic burdens on society. Older age is a known risk factor for falls and age has been shown to influence the effectiveness of fall prevention programs. To our knowledge, no studies have explicitly investigated whether cost-effectiveness of a multifactorial fall prevention intervention (the intervention) is influenced by age. This economic evaluation explores: 1) the cost-effectiveness of a multifactorial fall prevention intervention compared to usual care for community-dwelling adults >= 75 years at risk of falling in Canada; and 2) the influence of age on the cost-effectiveness of the intervention. Methods: Net benefit regression was used to examine the cost-effectiveness of the intervention with willingness-to-pay values ranging from $0-$ 50,000. Effects were measured as change in the number of falls, from baseline to 6-month follow-up. Costs were measured using a societal perspective. The cost-effectiveness analysis was conducted for both the total sample and by age subgroups (75-84 and 85+ years). Results: For the total sample, the intervention was not economically attractive. However, the intervention was cost-effective at higher willingness-to-pay (WTP) (>= $25,000) for adults 75-84 years and at lower WTP (< $5,000) for adults 85+ years. Conclusions: The cost-effectiveness of the intervention depends on age and decision makers' WTP to prevent falls. Understanding the influence of age on the cost-effectiveness of an intervention may help to target resources to those who benefit most.
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页数:7
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