Results from studies reporting intervention and total health care service costs
| Article, study sample, length of time, falls monitored | Interventions and number being compared, length of intervention phase | Type of currency, year of costs, time period costs measured | Costs measured | Intervention costs | Health care service costs | Measures 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 | |||||