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

Wanrudee Isaranuwatchai, Johnna Perdrizet, Maureen Markle-Reid, Jeffrey S Hoch, Wanrudee Isaranuwatchai, Johnna Perdrizet, Maureen Markle-Reid, Jeffrey S Hoch

Abstract

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).

Keywords: Age; Cost-effectiveness analysis; Fall prevention; Multifactorial intervention; Older adults.

Conflict of interest statement

Ethics approval and consent to participate

This study was conducted in accordance with the Tri-Council Policy Statement, “Ethical Conduct for Research Involving Humans” [45]. Ethics approval for the study was obtained from the McMaster University Research and Ethics Board and renewed yearly as required (# 05–279). All participants provided written informed consent for participation.

Consent for publication

N/A

Competing interests

The authors declare that they have no competing interests.

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Figures

Fig. 1
Fig. 1
A cost-effectiveness acceptability curve indicates the probability that the intervention is cost-effective compared to usual care for a given willingness-to-pay value. The y-axis represents the probability that the intervention was cost-effective, and the x-axis represents a range of willingness-to-pay values. Cost-effectiveness acceptability curves for all (75+ years), young-old (75-84 years), and old-old (85-95 years)

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Source: PubMed

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