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

Area of Science:

• Gerontology
• Health Economics
• Public Health

Background:

• Nursing home residents face a high risk of falls and fractures.
• Economic evaluations of fall prevention programs have largely overlooked this demographic.
• This study addresses the cost-effectiveness of a multifactorial fall prevention program specifically for nursing home residents.

Purpose of the Study:

• To analyze the cost-effectiveness of a multifactorial fall prevention program in nursing home residents.
• To determine the probability of cost-effectiveness given a willingness-to-pay threshold.

Main Methods:

• Prospective, unblinded, cluster, nonrandomized controlled study design.
• Analysis of claims data from a German sickness fund (AOK Bavaria) for residents aged 65+ in nursing homes.
• Health effects measured as time free of femoral fracture (ICD-10, S72); costs analyzed from a payer perspective.
• Multivariate regression, sensitivity analyses, and cost-effectiveness acceptability curves were employed.

Main Results:

• A significant reduction in femoral fracture rate was observed within the first year of the intervention.
• The incremental cost-effectiveness ratio (ICER) was 7,481 EUR per year free of femoral fracture.
• There is an 83% probability that the intervention is cost-effective at a willingness-to-pay of 50,000 EUR per year free of femoral fracture.

Conclusions:

• The fall prevention program demonstrates potential cost-effectiveness within the first year, contingent on decision-maker willingness-to-pay.
• Further research is recommended to broaden the scope of measured costs and health effects.