Economic evaluation of a community based exercise programme to prevent falls

Objective-To assess the incremental costs and cost effectiveness of impleme nting a home based muscle strengthening and balance retraining programme th at reduced falls and injuries in older women. Design-An economic evaluation carried out within a randomised controlled tr ial with two years of follow up. Participants were individually prescribed an exercise programme (exercise group, n=116) or received usual care and so cial visits (control group, n=117). Setting-17 general practices in Dunedin, New Zealand. Participants-Women aged 80 years and older living in the community and invi ted by their general practitioner to take part. Main outcome measures-Number of falls and injuries related to falls, costs of implementing the intervention, healthcare service costs resulting from f alls and total healthcare service costs during the trial. Cost effectivenes s was measured as the incremental cost of implementing the exercise program me per fall event prevented. Main results-27% of total hospital costs during the trial were related to f alls. However, there were no significant differences in health service cost s between the two groups. Implementing the exercise programme for one and t wo years respectively cost $314 and $265 (1995 New Zealand dollars) per fal l prevented, and $457 and $426 per fall resulting in a moderate or serious injury prevented. Conclusions-The 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 i n healthcare costs. However, the results reported will provide information on the cost effectiveness of th, programme for those making decisions on fa lls prevention strategies.