Table 3

Results from studies reporting intervention and total health care service costs

Article, study sample, length of time, falls monitoredInterventions and number being compared, length of intervention phaseType of currency, year of costs, time period costs measuredCosts measuredIntervention costsHealth care service costsMeasures of cost effectiveness
HMO, health maintenance organisation.
Note. None of the studies specified the perspective taken when measuring costs.
Personal communication with authors.
•Mulrow et al21:•One-on-one sessions with physical therapist (n=97) v friendly visits (n=97)•US dollars•Intervention charges (wages and fringe benefits for personnel time, travel expenses, equipment based on annual depreciation, overhead costs)•Mean charge per intervention participant $1220 (95% CI $412 to $1832)•Mean per participant $11 398 (95% CI $10 929 to $11 849), no difference between groups
•Residents (≥3 months) from 9 nursing homes, dependent in ≥2 activities of daily living, mean (SD) age intervention group 79.7 (8.5) years, control group 81.4 (7.9) years•4 months •Participants recruited 1992*•Nursing home, hospitalisation, physician and other health professional visits, emergency department visits, procedures, and medication charges estimated from reimbursement fees, reference prices and prevailing allowable charges•Mean charge per control participant $189 (95% CI $80 to $298)
•4 months•4 months
•Tinetti et al27 (also reported in Rizzo et al29):•Assessment and targeted intervention at home by nurse and physical therapist (n=153) v social visits (n=148)•US dollars•Intervention costs (development, equipment, personnel, travel, overheads)•Mean cost per intervention participant $891•Intervention cost per fall prevented $1947
•Patients from an HMO, community living, ≥1 of 8 targeted risk factor(s) for falls, mean (SD) age intervention group 78.3 (5.3) years, control group 77.5 (5.3) years•3 months (longer if necessary for exercise component), monthly phone calls to 6 months•Enrolment 1990 to 1992 •1 year •Intervention cost per fall resulting in medical care prevented $12 392
•1 year
•Rizzo et al29 (also reported in Tinetti et al27):•Assessment and targeted intervention at home by nurse and physical therapist (n=148 of 153) v social visits (n=140 of 148)•US dollars•Intervention costs (developmental and training, enrollment of participants, overheads, equipment, staff related expenses, environmental modifications)•Mean cost per intervention participant $905 (range $588 to $1346)•Mean for intervention group approximately $2000 less, median costs approximately $1000 more than control group•Intervention cost per fall prevented $1772 (calculated using mean costs), $1815 (using median costs), $2668 (using total intervention costs)
•Patients from an HMO, community living, ≥1 of 8 targeted risk factor(s) for falls, mean (SD) age 77.9 (5.3) years•3 months, maintenance phase (contacted monthly) to 6 months•1993 prices used•Charges from relevant source assigned to hospitalisation and emergency department, outpatient, home care and skilled nursing facility use•Incremental total costs per fall prevented <$0 (using mean costs), $2150 (using median costs)
•1 year •1 year from study entry
•Buchner et al24:•Centre based endurance training and/or strength training (n=75) v no active intervention (n=30)•US dollars•Hospital costs, ancillary outpatient costs from HMO computerised records•Hospitalised control participants more likely to have >$5000 hospital costs (p<0.05)
•Patients from an HMO, community living, mild deficits in strength and balance, mean age 75 (range 68 to 85) years•Supervised for 24–26 weeks then self supervised•Randomisation 1992−1993*
•Up to 25 months•Period 7 to 18 months after randomisation