Public health policy and practice
Economic evaluation of a community based exercise programme to
prevent falls
M Clare Robertsona, Nancy Devlinb, Paul Scuffhamc, Melinda M Gardnera, David M Buchnerd, A John Campbella
a Department of
Medical and Surgical Sciences, University of Otago Medical School,
Dunedin, New Zealand, b Department of Preventive
and Social Medicine,University of Otago Medical School, c York Health Economics Consortium, University of
York, UK, d University
of Washington, Seattle, Washington, USA
Correspondence to: Dr Robertson, Dunedin School of Medicine, PO Box 913, Dunedin, New Zealand (clare.robertson{at}stonebow.otago.ac.nz)
Accepted for publication 14 January 2001
OBJECTIVE
To assess
the incremental costs and cost effectiveness of implementing a home
based muscle strengthening and balance retraining programme that
reduced falls and injuries in older women.
DESIGNAn economic
evaluation carried out within a randomised controlled trial with two
years of follow up. Participants were individually prescribed an
exercise programme (exercise group, n=116) or received usual care and
social visits (control group, n=117).
SETTING17 general
practices in Dunedin, New Zealand.
PARTICIPANTSWomen
aged 80 years and older living in the community and invited by their
general practitioner to take part.
MAIN OUTCOME
MEASURESNumber of falls and injuries related to
falls, costs of implementing the intervention, healthcare service costs
resulting from falls and total healthcare service costs during the
trial. Cost effectiveness was measured as the incremental cost of
implementing the exercise programme per fall event prevented.
MAIN RESULTS27% of
total hospital costs during the trial were related to falls. However,
there were no significant differences in health service costs between
the two groups. Implementing the exercise programme for one and two
years respectively cost $314 and $265 (1995 New Zealand dollars) per
fall prevented, and $457 and $426 per fall resulting in a moderate or
serious injury prevented.
CONCLUSIONSThe costs
resulting from falls make up a substantial proportion of the hospital
costs for older people. Despite a reduction in falls as a result of
this home exercise programme there was no significant reduction in
healthcare costs. However, the results reported will provide
information on the cost effectiveness of the programme for those making
decisions on falls prevention strategies.
Keywords: falls; exercise; elderly
© 2001 by Journal of Epidemiology and Community Health
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