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

Abstract

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

• Cost-effectiveness analysis
• Fall prevention
• Age
• Older adults
• Multifactorial intervention