THE COST-EFFECTIVENESS OF HOME ASSESSMENT AND MODIFICATION TO REDUCE FALLS IN THE ELDERLY

Injury sustained through falling is a significant risk for the elderly and a significant burden on the health service. Although many risk fa ctors have been detected and interventions proposed, there remains lim ited evidence concerning the cost-effectiveness of fall prevention. Th is study addressed the cost-effectiveness of a home assessment and mod ification program hypothesised to reduce risk of falling for the indep endent elderly. Due to a lack of direct clinical trial evidence concer ning such an intervention, a decision analytic model was developed to simulate the potential costs and outcomes of the intervention. The mod el was developed using available published literature concerning injur y in the elderly, focusing on Australian data where possible. Cost-eff ectiveness was estimated as the cost per fall prevented and cost per i njury prevented. Over a one-year period, the incremental cost of intro ducing the intervention was $172 per person, resulting in an increment al cost per fall prevented of $1,721 and cost per injury prevented of $17,208. Over a 10-year period, the intervention resulted in a cost sa ving of $92 per person (i.e. dominance, with cost savings in addition to reduced falls and injuries). This analysis indicates that there is potential for considerable benefit to be gained from this intervention , in terms of less morbidity, fewer hospitalisations and, possibly, im proved quality of life. However, there results are based on a model co nstructed from various data sources and assumptions so, although resul ts are indicative, further research is required to provide firm data b efore definitive policy conclusions and recommendations may be made.