Literature DB >> 22695789

Community falls prevention for people who call an emergency ambulance after a fall: an economic evaluation alongside a randomised controlled trial.

Tracey H Sach1, Philippa A Logan, Carol A C Coupland, John R F Gladman, Opinder Sahota, Valarie Stoner-Hobbs, Kate Robertson, Vicki Tomlinson, Marie Ward, Anthony J Avery.   

Abstract

OBJECTIVE: we estimated the cost-effectiveness of a community falls prevention service compared with usual care from a National Health Service and personal social services perspective over the 12 month trial period.
DESIGN: a cost-effectiveness and cost utility analysis alongside a randomised controlled trial
SETTING: community. PARTICIPANTS: people over 60 years of age living at home or in residential care who had fallen and called an emergency ambulance but were not taken to hospital.
INTERVENTIONS: referral to community fall prevention services or usual health and social care. MEASUREMENTS: incremental cost per fall prevented and incremental cost per Quality-Adjusted Life Years (QALYs)
RESULTS: a total of 157 participants (82 interventions and 75 controls) were used to perform the economic evaluation. The mean difference in NHS and personal social service costs between the groups was £-1,551 per patient over 1 year (95% CI: £-5,932 to £2,829) comparing the intervention and control groups. The intervention patients experienced on average 5.34 fewer falls over 12 months (95% CI: -7.06 to -3.62). The mean difference in QALYs was 0.070 (95% CI: -0.010 to 0.150) in favour of the intervention group.
CONCLUSION: the community falls prevention service was estimated to be cost-effective in this high-risk group. Current Controlled Trials ISRCTN67535605. (controlled-trials.com).

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Mesh:

Year:  2012        PMID: 22695789      PMCID: PMC3424053          DOI: 10.1093/ageing/afs071

Source DB:  PubMed          Journal:  Age Ageing        ISSN: 0002-0729            Impact factor:   10.668


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Review 1.  The death of cost-minimization analysis?

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3.  Measuring indirect costs: is there a problem?

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Review 6.  Multifactorial assessment and targeted intervention for preventing falls and injuries among older people in community and emergency care settings: systematic review and meta-analysis.

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Review 7.  Pulling cost-effectiveness analysis up by its bootstraps: a non-parametric approach to confidence interval estimation.

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8.  Risk factors for falls among elderly persons living in the community.

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10.  Incidence and costs of unintentional falls in older people in the United Kingdom.

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  11 in total

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Review 3.  Interventions for preventing falls in older people living in the community.

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5.  Cost-utility of medication withdrawal in older fallers: results from the improving medication prescribing to reduce risk of FALLs (IMPROveFALL) trial.

Authors:  Suzanne Polinder; Nicole D A Boyé; Francesco U S Mattace-Raso; Nathalie Van der Velde; Klaas A Hartholt; Oscar J De Vries; Paul Lips; Tischa J M Van der Cammen; Peter Patka; Ed F Van Beeck; Esther M M Van Lieshout
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6.  Trauma recidivism at an emergency department of a Swedish medical center.

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7.  Comparison of a group-delivered and individually delivered lifestyle-integrated functional exercise (LiFE) program in older persons: a randomized noninferiority trial.

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8.  Re-contact rates with a UK ambulance service following paramedic referral to a falls prevention service for those aged ≥ 65 years: a retrospective cohort study.

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Review 9.  Multifactorial and multiple component interventions for preventing falls in older people living in the community.

Authors:  Sally Hopewell; Olubusola Adedire; Bethan J Copsey; Graham J Boniface; Catherine Sherrington; Lindy Clemson; Jacqueline Ct Close; Sarah E Lamb
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10.  Ten years of EMS Fall Calls in a Community: An Opportunity for Injury Prevention Strategies.

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