Economic analysis of a community-based falls prevention program

Beard, J.; Rowell, D.; Scott, D.; van Beurden, E.; Barnett, L.; Hughes, K.; Newman, B.

doi:10.1016/j.puhe.2006.04.011

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Volume 120, Issue 8 , Pages 742-751, August 2006

Economic analysis of a community-based falls prevention program

J. Beard
- Northern Rivers University Department of Rural Health, University of Sydney, Southern Cross University, PO Box 3074, Lismore NSW 2480, Australia
- Injury Prevention and Control, Australia
- New York Academy of Medicine, New York, USA
- Corresponding author. Tel.: +61266207570; fax: +61266207270.
D. Rowell
- Southern Cross University, Lismore, Australia
D. Scott
- Southern Cross University, Lismore, Australia
E. van Beurden
- Southern Cross University, Lismore, Australia
- North Coast Area Health Service, Lismore, Australia
L. Barnett
- Northern Rivers University Department of Rural Health, University of Sydney, Southern Cross University, PO Box 3074, Lismore NSW 2480, Australia
K. Hughes
- Injury Prevention and Control, Australia
- Queensland University of Technology, Injury Prevention and Control, Brisbane, Australia
B. Newman
- Injury Prevention and Control, Australia
- Queensland University of Technology, Injury Prevention and Control, Brisbane, Australia

Received 3 June 2005; received in revised form 17 March 2006; accepted 12 April 2006.

Summary

Objectives

To undertake a cost–benefit analysis of ‘Stay on Your Feet’, a community-based falls prevention program targeting older people at all levels of risk in New South Wales, Australia. Hospital separations were monitored in the intervention region, a control region and for the state of New South Wales as a whole. Changing admission patterns over the intervention period were used to assess the impact of the program.

Methods

Cost–benefit analysis compared the costs of the program with two estimates of savings from avoided hospital admissions. The first compared the cost of hospital admissions in the intervention region to a control region of similar demographics, while the second compared hospital utilization in the intervention region with the state of New South Wales as a whole using falls-related hospital diagnosis related group (DRG) codes.

Results

The total direct costs of the program were estimated at A$781 829. Both methods identified clear overall net benefits ranging from A$5.4 million for avoided hospitalizations alone to A$16.9 million for all avoided direct and indirect costs. The confidence intervals around these estimates were small. The average overall benefit to cost ratio for the intervention as a whole was 20.6:1.

Conclusions

These findings suggest that well-designed community-based interventions targeting falls prevention among older people are highly cost effective and a wise investment for all levels of government. The models used are conservative and are likely to underestimate the real benefit of the intervention, which may have lasted for some time beyond the life of the program.

Keywords: Falls prevention, Cost–benefit analysis, Diagnosis-related groups, Net present value, Health promotion