@article{ref1,
title="Home safety assessment and modification to reduce injurious falls in community-dwelling older adults: cost-utility and equity analysis",
journal="Injury prevention",
year="2016",
author="Pega, Frank and Kvizhinadze, Giorgi and Blakely, Tony A. and Atkinson, June and Wilson, Nick",
volume="22",
number="6",
pages="420-426",
abstract="BACKGROUND: This study aimed to improve on previous modelling work to determine the health gain, cost-utility and health equity impacts from home safety assessment and modification (HSAM) for reducing injurious falls in older people. <br><br>METHODS: The model was a Markov macrosimulation one that estimated quality-adjusted life-years (QALYs) gained. The setting was a country with detailed epidemiological and cost data (New Zealand (NZ)) for 2011. A health system perspective was taken and a discount rate of 3% was used (for both health gain and costs). Intervention effectiveness estimates came from a Cochrane systematic review and NZ-specific intervention costs were from a randomised controlled trial. <br><br>RESULTS: In the 65 years and above age group, the HSAM programme cost a total of US$98 million (95% uncertainty interval (UI) US$65 to US$139 million) to implement nationally and the accrued net health system costs were US$74 million (95% UI: cost saving to US$132 million). Health gains were 34 000 QALYs (95% UI: 5000 to 65 000). The incremental cost-effectiveness ratio (ICER) was US$6000 (95% UI: cost saving to US$13 000), suggesting that HSAM is highly cost-effective. Targeting HSAM only to older people with previous injurious falls and to older people aged 75 years and above were also cost-effective (ICERs=US$1000 and US$11 000, respectively). There was no evidence for differential cost-effectiveness by gender or by ethnicity (Indigenous New Zealanders: Māori vs non-Māori). <br><br>CONCLUSIONS: As per other studies, this modelling study indicates that the provision of an HSAM intervention produces considerable health gain and is highly cost-effective among older people. Targeting this intervention to older people with previous injurious falls is a promising initial approach before any scale up. TRIAL REGISTRATION NUMBER: ACTRN12609000779279.<br><br>Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/<p /> <p>Language: en</p>",
language="en",
issn="1353-8047",
doi="10.1136/injuryprev-2016-041999",
url="http://dx.doi.org/10.1136/injuryprev-2016-041999"
}