A person-centred ehealth intervention for fall prevention in nursing homes lacking geriatric expertise:...

Falls among older adults in nursing homes are frequent and have serious consequences. They represent a major public health issue with significant costs.

To investigate the cost-effectiveness of a gerontological telemedicine programme in preventing falls among residents of nursing homes located in areas with limited access to primary care ('medical deserts').

GERONTACCESS was a prospective, longitudinal, randomised study. In this secondary analysis of that trial, 426 residents aged ≥60 years living in a nursing home located in a medical desert were included in an intervention group (IG) (participants in a preventive gerontological telemedicine programme) or a control group (CG) (those who received usual care). Data were collected between July 2016 and January 2018.

The study outcomes were the proportion of patients who experienced falls during the 1-year study period. The Incremental Cost Effectiveness Ratio was calculated. Data on each fall were collected every month. Direct costs were assessed following guidelines from the French National Authority for Health.

Over 1 year, 1086 falls were recorded, with no significant difference in total falls between the two groups. However, 980 non-serious falls (those that did not require medical assistance) were observed, involving 107 residents in the IG versus 134 residents in the CG (P = .006). Significantly fewer residents in the IG experienced at least one fall compared to the CG (P = .02). The cost analysis indicated that each fall avoided in the IG saved ~US$4272.

The gerontological telemedicine programme, is a cost-effective way to reduce the number of non-serious falls among residents. It maybe also delayed the timing of the first fall.