title: How much are we willing to pay to prevent a fall? Cost-effectiveness of a multifactorial falls prevention program for community-dwelling older adults.
abstract: This study examined the cost-effectiveness of a multifactorial falls prevention program and estimated the trade-off between the extra costs of such a program and the additional reduction of unintentional falls. Cost-effectiveness was evaluated using the traditional incremental cost-effectiveness ratio (ICER) and the net benefit regression framework (NBRF). Using the NBRF, decision making was formalized by incorporating values of willingness to pay (WTP) a priori. The results failed to provide evidence that a multifactorial falls prevention program was cost-effective. Participant adherence to recommendations ranged from low (41.3%), to moderate (21.1%), to high (37.6%). A future challenge is to understand more clearly the relationship between the community-dwelling older adult, potentially modifiable risks for falls, adherence to multifactorial risk factor recommendations, costs, and resulting effects of falls prevention practices. Future economic evaluations of falls prevention interventions remain necessary and should consider the NBRF so that regression tools can facilitate cost-effectiveness analysis.
authors.affiliation: Lawson Health Research Institute, St. Joseph's Health Care, Parkwood Hospital, London, Ontario, Canada. krista.brayjenkyn@sjhc.london.on.ca
authors.forename: Krista Bray
authors.initials: KB
authors.lastname: Jenkyn
authors.forename: Jeffrey S
authors.initials: JS
authors.lastname: Hoch
authors.forename: Mark
authors.initials: M
authors.lastname: Speechley
mesh_terms: D000058:Accidental Falls / Q000191:economics* / Q000517:prevention & control*; D000368:Aged; D000369:Aged, 80 and over; D002170:Canada; D003362:Cost-Benefit Analysis; D005260:Female; D006291:Health Policy / Q000191:economics; D006801:Humans; D057187:Independent Living / Q000191:economics*; D008297:Male; D011634:Public Health / Q000191:economics*; D012307:Risk Factors; D040242:Risk Reduction Behavior