Cost-effectiveness analysis of the digital fall preventive intervention Safe Step among community-dwelling older people aged 70 and older.

IF 3.7 2区 社会学 Q1 GERONTOLOGY European Journal of Ageing Pub Date : 2024-10-26 DOI:10.1007/s10433-024-00828-8
Saranda Bajraktari, Marlene Sandlund, Beatrice Pettersson, Erik Rosendahl, Magnus Zingmark
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Abstract

Falls are the most common cause of injury in older people, with consequences for the individual and society. With an increasing population of older people, falls and related costs are expected to increase. It is crucial to identify scalable and cost-effective interventions and subsequently reduce fall-related costs. The aim was to evaluate the cost-effectiveness of the Safe Step digital fall preventive exercise intervention over a period of 12 years and, in addition, to evaluate the impact of increased recruitment cost and decreased intervention effect. The intervention was evaluated in an observational study in a municipality context targeting community-dwelling older people of age 70 + . A Markov model with five states was used to model the cost-effectiveness of the Safe Step intervention and evaluate quality-adjusted life years (QALYs) and fall-related costs from a societal perspective. By using data from a meta-analysis as basis for the estimated intervention effect, the Safe Step intervention was compared with a no-intervention alternative. The results showed that the Safe Step intervention dominated no intervention. In the sensitivity analysis with the most conservative estimate of intervention effect, the ICER was €7 616 per QALY gained. Hence, Safe Step showed to be a cost-saving fall preventive intervention in older people at risk of falling and potentially cost-effective even with a low estimated intervention effect. Future studies on efficacy of fall preventive digital interventions will contribute in precising effect estimates and enhance the validity of these cost-effectiveness results.

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对 70 岁及以上居住在社区的老年人进行数字化跌倒预防干预 "安全步 "的成本效益分析。
跌倒是老年人最常见的受伤原因,对个人和社会都有影响。随着老年人口的增加,预计跌倒及相关费用也会增加。确定可推广且具有成本效益的干预措施,进而降低与跌倒相关的成本至关重要。该研究旨在评估 "安全阶梯 "数字化预防跌倒运动干预措施在 12 年内的成本效益,并评估招募成本增加和干预效果下降的影响。该干预措施是在一项观察性研究中进行评估的,研究对象是城市中居住在社区的 70 岁以上老年人。该研究使用了一个包含五个状态的马尔可夫模型来模拟 "安全阶梯 "干预措施的成本效益,并从社会角度评估了质量调整生命年(QALYs)和与跌倒相关的成本。通过使用荟萃分析的数据作为估计干预效果的基础,将安全阶梯干预措施与不采取干预措施的替代方案进行了比较。结果表明,"安全阶梯 "干预措施的效果优于不采取干预措施的效果。在对干预效果进行最保守估计的敏感性分析中,每 QALY 收益的 ICER 为 7 616 欧元。因此,对于有跌倒风险的老年人来说,"安全步 "是一种可节约成本的跌倒预防干预措施,即使干预效果估计值较低,也具有潜在的成本效益。未来对预防跌倒数字化干预效果的研究将有助于精确估算效果,并提高这些成本效益结果的有效性。
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来源期刊
CiteScore
6.50
自引率
7.90%
发文量
72
期刊介绍: The European Journal of Ageing: Social, Behavioural and Health Perspectives is an interdisciplinary journal devoted to the understanding of ageing in European societies and the world over. EJA publishes original articles on the social, behavioral and population health aspects of ageing and encourages an integrated approach between these aspects. Emphasis is put on publishing empirical research (including meta-analyses), but conceptual papers (including narrative reviews) and methodological contributions will also be considered. EJA welcomes expert opinions on critical issues in ageing. By stimulating communication between researchers and those using research findings, it aims to contribute to the formulation of better policies and the development of better practice in serving older adults. To further specify, with the term ''social'' is meant the full scope of social science of ageing related research from the micro to the macro level of analysis. With the term ''behavioural'' the full scope of psychological ageing research including life span approaches based on a range of age groups from young to old is envisaged. The term ''population health-related'' denotes social-epidemiological and public health oriented research including research on functional health in the widest possible sense.
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