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


TRIAL REGISTRATION
Retrospectively registered. Clinicaltrials.gov identifier: NCT00463658 (18 April 2007).
['Isaranuwatchai|Wanrudee|W|0000-0002-8368-6065', 'Perdrizet|Johnna|J|', 'Markle-Reid|Maureen|M|', 'Hoch|Jeffrey S|JS|']
D000058:Accidental Falls D000367:Age Factors D000368:Aged D000369:Aged, 80 and over D002170:Canada D003362:Cost-Benefit Analysis D005260:Female D015276:Health Care Rationing D006699:Home Care Services D006801:Humans D057187:Independent Living D008297:Male D011634:Public Health D018570:Risk Assessment D012307:Risk Factors
Cost-effectiveness analysis Fall prevention Older adults Age Multifactorial intervention