Modelling the cost-effectiveness of impact-absorbing flooring in Swedish residential care facilities.
Fall-related injuries among the elderly, specifically hip fractures, cause significant morbidity and mortality as well as imposing a substantial financial cost on the health care system. Impact-absorbing flooring has been advocated as an effective method for preventing hip fractures resulting from falls. This study identifies the cost-effectiveness of impact-absorbing flooring compared to standard flooring in residential care facilities for the elderly in a Swedish setting.



An incremental cost-effectiveness analysis was performed comparing impact-absorbing flooring to standard flooring using a Markov decision model. A societal perspective was adopted and incremental costs were compared to incremental gains in quality-adjusted life years (QALYs). Data on costs, probability transitions and health-related quality of life measures were retrieved from the published literature and from Swedish register data. Probabilistic sensitivity analysis was performed through a Monte Carlo simulation.



The base-case analysis indicates that the impact-absorbing flooring reduces costs and increases QALYs. When allowing for uncertainty we find that 60% of the simulations indicate that impact-absorbing flooring is cost-saving compared to standard flooring and an additional 20% that it has a cost per QALY below a commonly used threshold value



: Using a modelling approach, we find that impact-absorbing flooring is a dominant strategy at the societal level considering that it can save resources and improve health in a vulnerable population.
Swedish Civil Contingencies Agency, Karlstad, Sweden linda.ryen@msb.se.
Linda
L
Ryen
Department of Economics, Örebro University, Sweden Health Metrics, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
Mikael
M
Svensson
D000058:Accidental Falls / Q000191:economics* / Q000517:prevention & control; D000368:Aged; D003362:Cost-Benefit Analysis / Q000191:economics* / Q000379:methods / Q000706:statistics & numerical data; D005430:Floors and Floorcoverings / Q000191:economics* / Q000379:methods; D017048:Health Care Costs / Q000706:statistics & numerical data; D006620:Hip Fractures / Q000191:economics / Q000517:prevention & control*; D006707:Homes for the Aged; D006801:Humans; D008390:Markov Chains; D018803:Models, Economic; D013548:Sweden