title: Economic Evaluation of a Tai Ji Quan Intervention to Reduce Falls in People With Parkinson Disease, Oregon, 2008-2011.
abstract: BACKGROUND
  Exercise is effective in reducing falls in people with Parkinson disease. However, information on the cost effectiveness of this approach is lacking. We conducted a cost-effectiveness analysis of Tai Ji Quan for reducing falls among patients with mild-to-moderate Parkinson disease.
  
  
  METHODS
  We used data from a previous intervention trial to analyze resource use costs related to intervention delivery and number of falls observed during a 9-month study period. Cost effectiveness was estimated via incremental cost-effectiveness ratio (ICER) in which Tai Ji Quan was compared with 2 alternative interventions (Resistance training and Stretching) on the primary outcome of per fall prevented and the secondary outcome of per participant quality-adjusted life years (QALY) gained. We also conducted subgroup and sensitivity analyses.
  
  
  RESULTS
  Tai Ji Quan was more effective than either Resistance training or Stretching; it had the lowest cost and was the most effective in improving primary and secondary outcomes. Compared with Stretching, Tai Ji Quan cost an average of $175 less for each additional fall prevented and produced a substantial improvement in QALY gained at a lower cost. Results from subgroup and sensitivity analyses showed no variation in cost-effectiveness estimates. However, sensitivity analyses demonstrated a much lower ICER ($27) when only intervention costs were considered.
  
  
  CONCLUSIONS
  Tai Ji Quan represents a cost-effective strategy for optimizing spending to prevent falls and maximize health gains in people with Parkinson disease. While these results are promising, they warrant further validation.
authors.affiliation: Oregon Research Institute, 1776 Millrace Dr, Eugene, OR 97403. Email: fuzhongl@ori.org.
authors.forename: Fuzhong
authors.initials: F
authors.lastname: Li
authors.affiliation: Willamette University, Salem, Oregon.
authors.forename: Peter
authors.initials: P
authors.lastname: Harmer
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D006801:Humans; D008875:Middle Aged; D000058:Accidental Falls / Q000517:prevention & control / Q000706:statistics & numerical data; D003153:Community Health Services; D003362:Cost-Benefit Analysis; D005500:Follow-Up Studies; D006293:Health Promotion / Q000191:economics / Q000379:methods; D006304:Health Status; D052580:Muscle Stretching Exercises; D009922:Oregon / Q000453:epidemiology; D010300:Parkinson Disease / Q000150:complications / Q000473:pathology / Q000628:therapy; D010342:Patient Acceptance of Health Care; D004856:Postural Balance / Q000502:physiology; D019057:Quality-Adjusted Life Years; D055070:Resistance Training / Q000191:economics / Q000379:methods; D057566:Self Report; D012680:Sensitivity and Specificity; D011795:Surveys and Questionnaires; D026302:Tai Ji / Q000191:economics / Q000379:methods; D016896:Treatment Outcome