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Cost-effectiveness of a multifactorial fracture prevention program for elderly people admitted to nursing homes

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Abstract

Background

Fractures are one of the most costly consequences of falls in elderly patients in nursing homes.

Objectives

To compare the cost-effectiveness of a ‘multifactorial fracture prevention program’ provided by a multidisciplinary team with ‘no prevention’ in newly admitted nursing home residents.

Methods

We performed a cost-utility analysis using a Markov-based simulation model to establish the effectiveness of a multifaceted fall prevention program from the perspective of statutory health insurance (SHI) and long-term care insurance (LCI). The rate of falls was used to estimate the clinical and economic consequences resulting from hip and upper limb fractures. Robustness of the results was assessed using deterministic and probabilistic sensitivity analyses.

Results

Compared to no prevention a multifactorial prevention program for nursing home residents resulted in a cost-effectiveness ratio of €21,353 per quality-adjusted life-year. The total costs for SHI/LCI would result in €1.7 million per year. Results proved to be robust following deterministic and probabilistic sensitivity analyses.

Conclusion

Multifactorial fracture prevention appears to be cost-effective in preventing fractures in nursing home residents. Since the results were based on the number of falls further research is required to confirm the results.

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Authors and Affiliations

  1. Cologne Institute for Health Economics and Clinical Epidemiology, The University Hospital of Cologne (AöR), Cologne, Germany

    Dirk Müller, Lisa Borsi, Claudia Stracke & Stephanie Stock

  2. Helmholtz Zentrum München (GmbH), German Research Center for Environmental Health, Institute of Health Economics and Health Care Management (IGM), Munich, Germany

    Björn Stollenwerk

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  1. Dirk Müller
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  2. Lisa Borsi
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Correspondence to Dirk Müller.

Appendix

Appendix

See Tables 4, 5 and 6.

Table 4 Quarterly probabilities of incidence of hip and upper limb fractures in year 1 of the nursing home stay
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Table 5 Information about parameters used for the probabilistic sensitivity analysis
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Table 6 Results of the deterministic sensitivity analyses
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Müller, D., Borsi, L., Stracke, C. et al. Cost-effectiveness of a multifactorial fracture prevention program for elderly people admitted to nursing homes. Eur J Health Econ 16, 517–527 (2015). https://doi.org/10.1007/s10198-014-0605-5

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  • DOI: https://doi.org/10.1007/s10198-014-0605-5

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