Cost-effectiveness of a multifactorial fall prevention program in nursing homes
Summary The purpose of this study was to analyze the cost-effectiveness of a multifactorial fall prevention program in nursing home residents. Given a willingness-to-pay (WTP) of 50,000 EUR per year free of femoral fracture, the probability that the intervention is cost-effective is 83 %. Introducti...
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| creator | Heinrich, S. Rapp, K. Stuhldreher, N. Rissmann, U. Becker, C. König, H.-H. |
| description | Summary
The purpose of this study was to analyze the cost-effectiveness of a multifactorial fall prevention program in nursing home residents. Given a willingness-to-pay (WTP) of 50,000 EUR per year free of femoral fracture, the probability that the intervention is cost-effective is 83 %.
Introduction
Despite their increased risk of falls and fractures, nursing home residents have been neglected in economic evaluations of fall prevention programs so far. The purpose of this study was to analyze, for the first time, the cost-effectiveness of a multifactorial fall prevention program in nursing home residents.
Methods
This study is part of a prospective, unblinded, cluster, nonrandomized, controlled study focusing on the transfer of an efficacious fall prevention program into a real-world setting. The analyzed subsample was derived from claims data and consisted of data on intervention (
n
= 256, residents
n
= 10,178) and control homes (
n
= 893, residents
n
= 22,974), representing all insurants of a sickness fund (AOK Bavaria, Germany) who were 65 years or older, residing in a nursing home on the 31st of March 2007 and had a level of care of ≥1 according to the classification of the statutory long-term care insurance. Time free of femoral fracture (ICD-10, S72) was used as measure of health effects. Femoral fracture-related costs and intervention costs were measured from a payer perspective. Multivariate regression models were applied. Sensitivity analyses were performed and cost-effectiveness acceptability curves computed.
Results
Within the first year of the intervention, femoral fracture rate was significantly reduced, resulting in a nonsignificant incremental mean time of 1.41 days free of femoral fracture. Incremental mean total direct costs were 29 EUR per resident, which was not significant. The incremental cost-effectiveness ratio (ICER) was 7,481 EUR per year free of femoral fracture. The probability of an ICER |
| doi_str_mv | 10.1007/s00198-012-2075-x |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_1323815676</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>1323815676</sourcerecordid><originalsourceid>FETCH-LOGICAL-c405t-57e150e7437d7591d2f6b906fca3118857666350bc508524ad2f3b4063964f093</originalsourceid><addsrcrecordid>eNqNkU9LwzAYh4Mobk4_gBcpePESfZM0SXOU4T8QdlHwFrIumR1tM5NW5rc3o1NEELwkgTy_X_LyIHRK4JIAyKsIQFSBgVBMQXK82UNjkjOGqRJ8H41BMYlVTl5G6CjGFaSMUvIQjSgtQHAux2g29bHD1jlbdtW7bW2MmXeZyZq-7ipnys6HytSZM3WdrYNNSFf5Nh39Mpgmq9qs7UOs2mX26hsbj9FBQqM92e0T9Hx78zS9x4-zu4fp9SMuc-Ad5tISDlbmTC4kV2RBnZgrEK40jJCi4FIIwTjMSw4Fp7lJAJvnIJgSuUtzTdDF0Js-8tbb2OmmiqWta9Na30dNGGUF4UKKf6BEEcEVYwk9_4WufB_aNMiWKgomIC0TRAaqDD7GYJ1eh6ox4UMT0FsxehCjkxi9FaM3KXO2a-7njV18J75MJIAOQExX7dKGH0__2foJH76XFw</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1318836088</pqid></control><display><type>article</type><title>Cost-effectiveness of a multifactorial fall prevention program in nursing homes</title><source>MEDLINE</source><source>SpringerLink Journals</source><creator>Heinrich, S. ; Rapp, K. ; Stuhldreher, N. ; Rissmann, U. ; Becker, C. ; König, H.-H.</creator><creatorcontrib>Heinrich, S. ; Rapp, K. ; Stuhldreher, N. ; Rissmann, U. ; Becker, C. ; König, H.-H.</creatorcontrib><description>Summary
The purpose of this study was to analyze the cost-effectiveness of a multifactorial fall prevention program in nursing home residents. Given a willingness-to-pay (WTP) of 50,000 EUR per year free of femoral fracture, the probability that the intervention is cost-effective is 83 %.
Introduction
Despite their increased risk of falls and fractures, nursing home residents have been neglected in economic evaluations of fall prevention programs so far. The purpose of this study was to analyze, for the first time, the cost-effectiveness of a multifactorial fall prevention program in nursing home residents.
Methods
This study is part of a prospective, unblinded, cluster, nonrandomized, controlled study focusing on the transfer of an efficacious fall prevention program into a real-world setting. The analyzed subsample was derived from claims data and consisted of data on intervention (
n
= 256, residents
n
= 10,178) and control homes (
n
= 893, residents
n
= 22,974), representing all insurants of a sickness fund (AOK Bavaria, Germany) who were 65 years or older, residing in a nursing home on the 31st of March 2007 and had a level of care of ≥1 according to the classification of the statutory long-term care insurance. Time free of femoral fracture (ICD-10, S72) was used as measure of health effects. Femoral fracture-related costs and intervention costs were measured from a payer perspective. Multivariate regression models were applied. Sensitivity analyses were performed and cost-effectiveness acceptability curves computed.
Results
Within the first year of the intervention, femoral fracture rate was significantly reduced, resulting in a nonsignificant incremental mean time of 1.41 days free of femoral fracture. Incremental mean total direct costs were 29 EUR per resident, which was not significant. The incremental cost-effectiveness ratio (ICER) was 7,481 EUR per year free of femoral fracture. The probability of an ICER < 50,000 EUR per year free of femoral fracture was 83 %.
Conclusion
Depending on the amount the decision-maker is willing to pay for the incremental effect, the fall prevention program might be cost-effective within the first year. Future studies should expand the range of costs and effects measured.</description><identifier>ISSN: 0937-941X</identifier><identifier>EISSN: 1433-2965</identifier><identifier>DOI: 10.1007/s00198-012-2075-x</identifier><identifier>PMID: 22806557</identifier><language>eng</language><publisher>London: Springer-Verlag</publisher><subject>Accidental Falls - economics ; Accidental Falls - prevention & control ; Accidental Falls - statistics & numerical data ; Aged ; Aged, 80 and over ; Classification ; Cost-Benefit Analysis ; Data processing ; Economics ; Endocrinology ; Falls ; Female ; Femoral Fractures - economics ; Femoral Fractures - epidemiology ; Femoral Fractures - prevention & control ; Femur ; Fractures ; Germany - epidemiology ; Health Care Costs - statistics & numerical data ; Health care expenditures ; Health Promotion - economics ; Health Promotion - methods ; Homes for the Aged - economics ; Humans ; Male ; Medicine ; Medicine & Public Health ; Nursing ; Nursing homes ; Nursing Homes - economics ; Original Article ; Orthopedics ; Osteoporosis ; Prevention ; Program Evaluation ; Prospective Studies ; Regression analysis ; Rheumatology ; Sensitivity and Specificity</subject><ispartof>Osteoporosis international, 2013-04, Vol.24 (4), p.1215-1223</ispartof><rights>International Osteoporosis Foundation and National Osteoporosis Foundation 2012</rights><rights>International Osteoporosis Foundation and National Osteoporosis Foundation 2013</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c405t-57e150e7437d7591d2f6b906fca3118857666350bc508524ad2f3b4063964f093</citedby><cites>FETCH-LOGICAL-c405t-57e150e7437d7591d2f6b906fca3118857666350bc508524ad2f3b4063964f093</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s00198-012-2075-x$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s00198-012-2075-x$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,776,780,27901,27902,41464,42533,51294</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/22806557$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Heinrich, S.</creatorcontrib><creatorcontrib>Rapp, K.</creatorcontrib><creatorcontrib>Stuhldreher, N.</creatorcontrib><creatorcontrib>Rissmann, U.</creatorcontrib><creatorcontrib>Becker, C.</creatorcontrib><creatorcontrib>König, H.-H.</creatorcontrib><title>Cost-effectiveness of a multifactorial fall prevention program in nursing homes</title><title>Osteoporosis international</title><addtitle>Osteoporos Int</addtitle><addtitle>Osteoporos Int</addtitle><description>Summary
The purpose of this study was to analyze the cost-effectiveness of a multifactorial fall prevention program in nursing home residents. Given a willingness-to-pay (WTP) of 50,000 EUR per year free of femoral fracture, the probability that the intervention is cost-effective is 83 %.
Introduction
Despite their increased risk of falls and fractures, nursing home residents have been neglected in economic evaluations of fall prevention programs so far. The purpose of this study was to analyze, for the first time, the cost-effectiveness of a multifactorial fall prevention program in nursing home residents.
Methods
This study is part of a prospective, unblinded, cluster, nonrandomized, controlled study focusing on the transfer of an efficacious fall prevention program into a real-world setting. The analyzed subsample was derived from claims data and consisted of data on intervention (
n
= 256, residents
n
= 10,178) and control homes (
n
= 893, residents
n
= 22,974), representing all insurants of a sickness fund (AOK Bavaria, Germany) who were 65 years or older, residing in a nursing home on the 31st of March 2007 and had a level of care of ≥1 according to the classification of the statutory long-term care insurance. Time free of femoral fracture (ICD-10, S72) was used as measure of health effects. Femoral fracture-related costs and intervention costs were measured from a payer perspective. Multivariate regression models were applied. Sensitivity analyses were performed and cost-effectiveness acceptability curves computed.
Results
Within the first year of the intervention, femoral fracture rate was significantly reduced, resulting in a nonsignificant incremental mean time of 1.41 days free of femoral fracture. Incremental mean total direct costs were 29 EUR per resident, which was not significant. The incremental cost-effectiveness ratio (ICER) was 7,481 EUR per year free of femoral fracture. The probability of an ICER < 50,000 EUR per year free of femoral fracture was 83 %.
Conclusion
Depending on the amount the decision-maker is willing to pay for the incremental effect, the fall prevention program might be cost-effective within the first year. Future studies should expand the range of costs and effects measured.</description><subject>Accidental Falls - economics</subject><subject>Accidental Falls - prevention & control</subject><subject>Accidental Falls - statistics & numerical data</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Classification</subject><subject>Cost-Benefit Analysis</subject><subject>Data processing</subject><subject>Economics</subject><subject>Endocrinology</subject><subject>Falls</subject><subject>Female</subject><subject>Femoral Fractures - economics</subject><subject>Femoral Fractures - epidemiology</subject><subject>Femoral Fractures - prevention & control</subject><subject>Femur</subject><subject>Fractures</subject><subject>Germany - epidemiology</subject><subject>Health Care Costs - statistics & numerical data</subject><subject>Health care expenditures</subject><subject>Health Promotion - economics</subject><subject>Health Promotion - methods</subject><subject>Homes for the Aged - economics</subject><subject>Humans</subject><subject>Male</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Nursing</subject><subject>Nursing homes</subject><subject>Nursing Homes - economics</subject><subject>Original Article</subject><subject>Orthopedics</subject><subject>Osteoporosis</subject><subject>Prevention</subject><subject>Program Evaluation</subject><subject>Prospective Studies</subject><subject>Regression analysis</subject><subject>Rheumatology</subject><subject>Sensitivity and Specificity</subject><issn>0937-941X</issn><issn>1433-2965</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2013</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>BENPR</sourceid><recordid>eNqNkU9LwzAYh4Mobk4_gBcpePESfZM0SXOU4T8QdlHwFrIumR1tM5NW5rc3o1NEELwkgTy_X_LyIHRK4JIAyKsIQFSBgVBMQXK82UNjkjOGqRJ8H41BMYlVTl5G6CjGFaSMUvIQjSgtQHAux2g29bHD1jlbdtW7bW2MmXeZyZq-7ipnys6HytSZM3WdrYNNSFf5Nh39Mpgmq9qs7UOs2mX26hsbj9FBQqM92e0T9Hx78zS9x4-zu4fp9SMuc-Ad5tISDlbmTC4kV2RBnZgrEK40jJCi4FIIwTjMSw4Fp7lJAJvnIJgSuUtzTdDF0Js-8tbb2OmmiqWta9Na30dNGGUF4UKKf6BEEcEVYwk9_4WufB_aNMiWKgomIC0TRAaqDD7GYJ1eh6ox4UMT0FsxehCjkxi9FaM3KXO2a-7njV18J75MJIAOQExX7dKGH0__2foJH76XFw</recordid><startdate>20130401</startdate><enddate>20130401</enddate><creator>Heinrich, S.</creator><creator>Rapp, K.</creator><creator>Stuhldreher, N.</creator><creator>Rissmann, U.</creator><creator>Becker, C.</creator><creator>König, H.-H.</creator><general>Springer-Verlag</general><general>Springer Nature B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7QP</scope><scope>7RV</scope><scope>7TS</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8C1</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>KB0</scope><scope>M0S</scope><scope>M1P</scope><scope>NAPCQ</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope></search><sort><creationdate>20130401</creationdate><title>Cost-effectiveness of a multifactorial fall prevention program in nursing homes</title><author>Heinrich, S. ; Rapp, K. ; Stuhldreher, N. ; Rissmann, U. ; Becker, C. ; König, H.-H.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c405t-57e150e7437d7591d2f6b906fca3118857666350bc508524ad2f3b4063964f093</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2013</creationdate><topic>Accidental Falls - economics</topic><topic>Accidental Falls - prevention & control</topic><topic>Accidental Falls - statistics & numerical data</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Classification</topic><topic>Cost-Benefit Analysis</topic><topic>Data processing</topic><topic>Economics</topic><topic>Endocrinology</topic><topic>Falls</topic><topic>Female</topic><topic>Femoral Fractures - economics</topic><topic>Femoral Fractures - epidemiology</topic><topic>Femoral Fractures - prevention & control</topic><topic>Femur</topic><topic>Fractures</topic><topic>Germany - epidemiology</topic><topic>Health Care Costs - statistics & numerical data</topic><topic>Health care expenditures</topic><topic>Health Promotion - economics</topic><topic>Health Promotion - methods</topic><topic>Homes for the Aged - economics</topic><topic>Humans</topic><topic>Male</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Nursing</topic><topic>Nursing homes</topic><topic>Nursing Homes - economics</topic><topic>Original Article</topic><topic>Orthopedics</topic><topic>Osteoporosis</topic><topic>Prevention</topic><topic>Program Evaluation</topic><topic>Prospective Studies</topic><topic>Regression analysis</topic><topic>Rheumatology</topic><topic>Sensitivity and Specificity</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Heinrich, S.</creatorcontrib><creatorcontrib>Rapp, K.</creatorcontrib><creatorcontrib>Stuhldreher, N.</creatorcontrib><creatorcontrib>Rissmann, U.</creatorcontrib><creatorcontrib>Becker, C.</creatorcontrib><creatorcontrib>König, H.-H.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Calcium & Calcified Tissue Abstracts</collection><collection>Nursing & Allied Health Database</collection><collection>Physical Education Index</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Public Health Database</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Nursing & Allied Health Premium</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><jtitle>Osteoporosis international</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Heinrich, S.</au><au>Rapp, K.</au><au>Stuhldreher, N.</au><au>Rissmann, U.</au><au>Becker, C.</au><au>König, H.-H.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Cost-effectiveness of a multifactorial fall prevention program in nursing homes</atitle><jtitle>Osteoporosis international</jtitle><stitle>Osteoporos Int</stitle><addtitle>Osteoporos Int</addtitle><date>2013-04-01</date><risdate>2013</risdate><volume>24</volume><issue>4</issue><spage>1215</spage><epage>1223</epage><pages>1215-1223</pages><issn>0937-941X</issn><eissn>1433-2965</eissn><abstract>Summary
The purpose of this study was to analyze the cost-effectiveness of a multifactorial fall prevention program in nursing home residents. Given a willingness-to-pay (WTP) of 50,000 EUR per year free of femoral fracture, the probability that the intervention is cost-effective is 83 %.
Introduction
Despite their increased risk of falls and fractures, nursing home residents have been neglected in economic evaluations of fall prevention programs so far. The purpose of this study was to analyze, for the first time, the cost-effectiveness of a multifactorial fall prevention program in nursing home residents.
Methods
This study is part of a prospective, unblinded, cluster, nonrandomized, controlled study focusing on the transfer of an efficacious fall prevention program into a real-world setting. The analyzed subsample was derived from claims data and consisted of data on intervention (
n
= 256, residents
n
= 10,178) and control homes (
n
= 893, residents
n
= 22,974), representing all insurants of a sickness fund (AOK Bavaria, Germany) who were 65 years or older, residing in a nursing home on the 31st of March 2007 and had a level of care of ≥1 according to the classification of the statutory long-term care insurance. Time free of femoral fracture (ICD-10, S72) was used as measure of health effects. Femoral fracture-related costs and intervention costs were measured from a payer perspective. Multivariate regression models were applied. Sensitivity analyses were performed and cost-effectiveness acceptability curves computed.
Results
Within the first year of the intervention, femoral fracture rate was significantly reduced, resulting in a nonsignificant incremental mean time of 1.41 days free of femoral fracture. Incremental mean total direct costs were 29 EUR per resident, which was not significant. The incremental cost-effectiveness ratio (ICER) was 7,481 EUR per year free of femoral fracture. The probability of an ICER < 50,000 EUR per year free of femoral fracture was 83 %.
Conclusion
Depending on the amount the decision-maker is willing to pay for the incremental effect, the fall prevention program might be cost-effective within the first year. Future studies should expand the range of costs and effects measured.</abstract><cop>London</cop><pub>Springer-Verlag</pub><pmid>22806557</pmid><doi>10.1007/s00198-012-2075-x</doi><tpages>9</tpages></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0937-941X |
| ispartof | Osteoporosis international, 2013-04, Vol.24 (4), p.1215-1223 |
| issn | 0937-941X 1433-2965 |
| language | eng |
| recordid | cdi_proquest_miscellaneous_1323815676 |
| source | MEDLINE; SpringerLink Journals |
| subjects | Accidental Falls - economics Accidental Falls - prevention & control Accidental Falls - statistics & numerical data Aged Aged, 80 and over Classification Cost-Benefit Analysis Data processing Economics Endocrinology Falls Female Femoral Fractures - economics Femoral Fractures - epidemiology Femoral Fractures - prevention & control Femur Fractures Germany - epidemiology Health Care Costs - statistics & numerical data Health care expenditures Health Promotion - economics Health Promotion - methods Homes for the Aged - economics Humans Male Medicine Medicine & Public Health Nursing Nursing homes Nursing Homes - economics Original Article Orthopedics Osteoporosis Prevention Program Evaluation Prospective Studies Regression analysis Rheumatology Sensitivity and Specificity |
| title | Cost-effectiveness of a multifactorial fall prevention program in nursing homes |
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