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Published on: October 6, 2016
Economic evaluation of the e-Health StandingTall balance exercise programme for fall prevention in people aged
Meghan Ambrens1,2, Kimberley S van Schooten2,3, Thomas Lung4,5
1School of Health, Medicine and Applied Science, Appleton Institute, CQUniversity, Melbourne, VIC, Australia.
Background:
globally, falls and fall-related injuries are the leading cause of injury-related morbidity and mortality in older people. In our ageing society healthcare costs are increasing, therefore programmes that reduce falls and are considered value for money are needed.
Objective:
to complete an economic evaluation of an e-Health balance exercise programme that reduced falls and injurious falls in community-dwelling older people compared to usual care from a health and community-care funder perspective.
Design:
a within-trial economic evaluation of an assessor-blinded randomised controlled trial with 2 years of follow-up.
Setting:
StandingTall was delivered via tablet-computer at home to older community-dwelling people in Sydney, Australia.
Participants:
five hundred and three individuals aged 70+ years who were independent in activities of daily living, without cognitive impairment, progressive neurological disease or any other unstable or acute medical condition precluding exercise.
Main Outcome Measures:
cost-effectiveness was measured as the incremental cost per fall and per injurious fall prevented. Cost-utility was measured as the incremental cost per quality-adjusted life year (QALY) gained.
Main Results:
the total average cost per patient for programme delivery and care resource cost was $8,321 (standard deviation [SD] 18,958) for intervention participants and $6,829 (SD 15,019) for control participants. The incremental cost per fall prevented was $4,785 and per injurious fall prevented was $6,585. The incremental cost per QALY gained was $58,039 (EQ5D-5L) and $110,698 (AQoL-6D).
Conclusion:
this evaluation found that StandingTall has the potential to be cost-effective in specific subpopulations of older people, but not necessarily the whole older population.
Trial Registration:
ACTRN12615000138583.
