Citation

Scheckel B, Stock S, Müller D. BMC Geriatr. 2021; 21(1): e440.

Copyright

(Copyright © 2021, Holtzbrinck Springer Nature Publishing Group - BMC)

DOI

10.1186/s12877-021-02329-0

PMID

unavailable

Abstract

BACKGROUND: Clinical studies indicate that strength-balance training for active fall prevention can prevent fractures in older people. The present modelling study evaluates the cost-effectiveness of fall prevention exercise (FPE) provided to independently living older people compared to no intervention in Germany.

METHOD: We designed a Markov model to evaluate the cost-effectiveness of a group-based FPE-program provided to independently living people ≥75 years from the perspective of the German statutory health insurance (SHI). Input data was obtained from public databases, clinical trials and official statistics. The incremental cost-effectiveness ratio (ICER) was presented as costs per avoided hip fracture. Additionally, we performed deterministic and probabilistic sensitivity analyses and, estimated monetary consequences for the SHI in a budget impact analysis (BIA).

RESULTS: For women, the costs per hip fracture avoided amounted to €52,864 (men: €169,805).

RESULTS of deterministic and probabilistic sensitivity analyses confirmed the robustness of the results. According to the BIA, for the reimbursement of FPE additional costs of €3.0 million (women) and €7.8 million (men) are expected for the SHI.

CONCLUSIONS: Group-based FPE appears to be no cost-effective option to prevent fall-related hip fractures in independently living elderly. To allow a more comprehensive statement on the cost effectiveness of FPE fracture types other than hip should be increasingly evaluated in clinical trials.

Language: en

Keywords

Elderly people; Fall prevention; Cost-effectiveness; Hip fracture; Markov model