Topic 9 supplement: Value for money from falls prevention interventions

12 May 2017 | Reducing Harm from Falls

This is an excerpt from Falling costs: the case for investment. The full report can be found by clicking here.

The biggest opportunities for cost savings occur in community living older people where the major cost drivers are hospital and aged care facility admissions.

The aim is to invest in health care services that incorporate the strategies proven to be effective and cost-effective in reducing these common events. Three falls prevention programmes have been shown to be cost saving to the health system in the first year of delivery and several others show good value for money.[1]

Return on investment has been estimated for several programmes delivered to specific subgroups and this ranges from 1.0 to 7.0 (Table 5).

This means that for every $100,000 invested by a district health board, the investment will be cost neutral or there could be up to $700,000 available within one year to allocate to other effective and worthwhile budget items.

Estimations for reduction in hospital admissions for these programmes range from 0.5 percent to 10.0 percent.

Impact of effective falls prevention interventions
Intervention Target group Reduction in number of falls Cost per client (NZ$2008)[2] Return on investment Reduction in hospital admissions*
Otago exercise programme Community dwelling aged >80 years 30%[3] $213-$549 1.9[4] 10.0
Vitamin D supplements Aged care facility residents 37%[5] Minimal 7.0** Not available
Home safety and modification by OT On discharge from hospital to community, previous faller aged >65 years 36%[5] $251-$369 Not available 4.7%
Tai Chi classes Community dwelling aged >70 years 28%[5] $303-$373 1.6[6] 0.5%
Multifactorial interventions Aged >65 years presenting to ED after a fall 59%[7] $1870 1.0[8] 2.0%
Stepping On Community dwelling aged >70 years with fall in previous year 31%[9] $885 1.0[6] Not available

* "Reduction in fall related hospital admissions for community dwelling 65+ years ($)"[10]
** ACC perspective only (personal communication, August 2012)
OT = occupational therapist

References

  1.  Davis JC, Robertson MC, Ashe MC, Liu-Ambrose T, Khan KM, CA M. Does a home - based strength and balance programme in people aged ≥80 years provide the best value for money to prevent falls? A systematic review of economic analyses of falls prevention interventions. Br J Sports Med 2010;44:80-9.
  2.  Robertson MC, Campbell AJ. Optimisation of ACC's fall prevention programmes for older people. Dunedin, New Zealand: University of Otago, November 2008.
  3.  Robertson MC, Campbell AJ, Gardner MM, Devlin N. Preventing injuries in older people by preventing falls: a meta-analysis of individual-level data. J Am Geriatr Soc 2002;50(5):905-11.
  4.  Hektoen LF, Aas E, Luras H. Cost-effectiveness in fall prevention for older women. Scand J Public Health 2009;37(6):584-9.
  5.  Gillespie LD, Robertson MC, Gillespie WJ, Sherrington C, Gates S, Clemson LM, et al. Interventions for preventing falls in older people living in the community. Cochrane Database Sys Rev 2012(9): Art. No.:CD007146.
  6.  Carande-Kulis VG, Stevens J, Beattie BL, Arias I. The business case for interventions to prevent fall injuries in older adults. Inj Prev 2010;16(Suppl 1):A249.
  7.  Close J, Ellis M, Hooper R, Glucksman E, Jackson S, Swift C. Prevention of falls in the elderly trial (PROFET): a randomised controlled trial. Lancet 1999;353:93-97.
  8.  Close JCT, Patel A, Hooper R, Glucksman E, Jackson SHD, Swift CG. PROFET – improved clinical outcomes at no additional cost. Age Ageing 2000;29(Suppl 1):48.
  9.  Clemson L, Cumming RG, Kendig H, Swann M, Heard R, Taylor K. The effectiveness of a community-based program for reducing the incidence of falls in the elderly: a randomized trial. J Am Geriatr Soc 2004;52(9):1487-94.
  10.  Day L, Hoareau E, Finch C, Harrison J, Segal L, Bolton T, et al. Modelling the impact, costs and benefits of falls prevention measures to support policy-makers and program planners. Melbourne, Australia: Monash University Accident Research Centre, September 2008.

Last updated 12/11/2019