RESPOND: a programme to prevent secondary falls in older people presenting to the emergency department with a fall: protocol for an economic evaluation.
Falls remain common for community-dwelling older people and impose a substantial economic burden to the healthcare system. RESPOND is a novel falls prevention programme that aims to reduce secondary falls and fall injuries among older people who present to a hospital emergency department (ED) with a fall. The present protocol describes a prospective economic evaluation examining the incremental cost-effectiveness of the RESPOND programme, compared with usual care practice, from the Australian health system perspective.



This economic evaluation will recruit 528 participants from two major tertiary hospital EDs in Australia and will be undertaken alongside a multisite randomised controlled trial. Outcome and costing data will be collected for all participants over the 12-month trial. It will compare the RESPOND falls prevention programme with usual care practice (current community-based falls prevention practices) to determine its incremental cost-effectiveness according to three intermediate clinical outcomes: (1) falls prevented, (2) fall injuries prevented and (3) injurious falls prevented. In addition, utilities will be derived from a generic quality-of-life measure (EQ-5D-5L) and used to calculate the 'incremental cost per quality-adjusted life years gained'.



The results of this study will provide healthcare decision makers with evidence to assist with setting spending thresholds for preventive health programmes and inform selection of emergency and community service models of care.



The protocol for this study is registered with the Australian New Zealand Clinical Trials Registry (ACTRN12614000336684); Pre-results.
Health Services Research Unit, Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Victoria, Australia.
R T
RT
Morello
Health Services Research Unit, Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Victoria, Australia.
R L
RL
Morris
School of Physiotherapy and Exercise Science, Curtin University, Perth, Western Australia, Australia.
K D
KD
Hill
Department of Physiotherapy, Monash University, Allied Health Research Unit, Monash Health, Melbourne, Victoria, Australia.
T P
TP
Haines
School of Primary, Aboriginal and Rural Health Care, University of Western Australia, Nedlands, Western Australia, Australia.
G
G
Arendts
The George Institute for Global Health, Sydney Medical School, University of Sydney, Camperdown, New South Wales, Australia.
J
J
Redfern
University of Western Australia, Perth, Western Australia, Australia.|Western Australian Institute for Medical Research, Perth, Western Australia, Australia.
C D
CD
Etherton-Beer
Pre-Hospital, Emergency and Trauma Unit, Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Victoria, Australia.
J A
JA
Lowthian
Health Services Research Unit, Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Victoria, Australia.
C A
CA
Brand
Health Services Research Unit, Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Victoria, Australia.
D
D
Liew
Centre for Population Health Research, Deakin University, Melbourne, Victoria, Australia.
J J
JJ
Watts
Health Services Research Unit, Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Victoria, Australia.
A L
AL
Barker
D000058:Accidental Falls / Q000191:economics / Q000517:prevention & control*; D000368:Aged; D000369:Aged, 80 and over; D001315:Australia; D002985:Clinical Protocols; D003362:Cost-Benefit Analysis; D004636:Emergency Service, Hospital / Q000191:economics / Q000706:statistics & numerical data*; D005260:Female; D006760:Hospitalization / Q000191:economics / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D011314:Preventive Health Services / Q000191:economics / Q000458:organization & administration; D015397:Program Evaluation; D011446:Prospective Studies; D019057:Quality-Adjusted Life Years; D018570:Risk Assessment; D014947:Wounds and Injuries / Q000191:economics / Q000517:prevention & control*