Universität zu Köln

Kunigkeit, Christopher, Stock, Stephanie ORCID: 0000-0002-1726-9300 and Mueller, Dirk (2018). Cost-effectiveness of a home safety intervention to prevent falls in impaired elderly people living in the community. Arch. Osteoporos., 13 (1). LONDON: SPRINGER LONDON LTD. ISSN 1862-3514

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Abstract

PurposeAmong others, the German National Prevention Conference recently recommended the provision of preventive options for elderly to maintain their independent living. Because a home safety assessment and modification program (HSM) has shown to be effective in avoiding falls and risk of falling in elderly, the aim of this analysis was to evaluate the cost-effectiveness of HSM in patients aged 80years who receive non-institutionalized long-term care.MethodsIn order to reflect quality-adjusted life years (QALYs) and costs resulting from HSM, a Markov-model with a time horizon of 20years was performed from the perspective of the German statutory health insurance (SHI) and statutory long-term care insurance (LCI). The model assumed that HSM reduces fall-related hip fractures in accordance with the reduction of the rate of falls. Data was obtained from public databases and from various literature searches. The robustness of the results was assessed in deterministic and probabilistic sensitivity analyses.ResultsIn women, the incremental cost-effectiveness ratio of HSM compared to no prevention was Euro9580 per QALY, while in men, it was Euro57,589. For the German SHI/LCI, in total, the provision of HSM to patients 80years who receive non-institutionalized long-term care would result in annual costs of Euro7.7 million. The results were robust in several sensitivity analyses.ConclusionsProvided that the rate of falls is a valid surrogate endpoint for the rate of fall-related hip fractures, HSM could be a promising approach for investments in preventive options targeting the reduction of fall-related fractures in elderly women.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Kunigkeit, Christopher UNSPECIFIED UNSPECIFIED UNSPECIFIED Stock, Stephanie UNSPECIFIED orcid.org/0000-0002-1726-9300 UNSPECIFIED Mueller, Dirk UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-165848
DOI:	10.1007/s11657-018-0535-4
Journal or Publication Title:	Arch. Osteoporos.
Volume:	13
Number:	1
Date:	2018
Publisher:	SPRINGER LONDON LTD
Place of Publication:	LONDON
ISSN:	1862-3514
Language:	English
Faculty:	Faculty of Medicine
Divisions:	Faculty of Medicine > Sonstiges > Zentrum für Versorgungsforschung Köln
Subjects:	Medical sciences Medicine
Uncontrolled Keywords:	Keywords Language HIP FRACTURE; OLDER-PEOPLE; UTILITY ANALYSIS; OSTEOPOROSIS; RISK; MORTALITY; CARE; INJURIES; EFFICACY; RATES Multiple languages Endocrinology & Metabolism; Orthopedics Multiple languages
Refereed:	Yes
URI:	http://kups.ub.uni-koeln.de/id/eprint/16584