@article{ref1,
title="Non-pharmaceutical prevention of hip fractures - a cost-effectiveness analysis of a community-based elderly safety promotion program in Sweden",
journal="Cost effectiveness and resource allocation",
year="2008",
author="Johansson, Pia and Sadigh, Siv and Tillgren, Per and Rehnberg, Clas",
volume="6",
number="1",
pages="11-11",
abstract="ABSTRACT: BACKGROUND: Elderly injuries are a recognized public health concern and are due to two factors; osteoporosis and accidental falls. Several osteoporosis pharmaceuticals are considered cost-effective, but intervention programs aiming at preventing falls should also be subjected to economic evaluations. This study presents a cost-effectiveness analysis of a community-based elderly safety promotion program. METHODS: A five-year elderly safety promotion program combining environmental structural changes with individually based measures was implemented in a community in the metropolitan area of Stockholm, Sweden. The community had around 5,500 inhabitants aged 65+ years and a first hip fracture incidence of 10.7 per 1,000 in pre-intervention years 1990-1995. The intervention outcome was measured as avoided hip fractures, obtained from a register-based quasi-experimental longitudinal analysis with several control areas. The long-term consequences in societal costs and health effects due to the avoided hip fractures, conservatively assumed to be avoided for one year, were estimated with a Markov model based on Swedish data. The analysis holds the societal perspective and conforms to recommendations for pharmaceutical cost-effectiveness analyses. RESULTS: Total societal intervention costs amounted to 6.45 million SEK (in Swedish krona 2004; 1 Euro=9.13 SEK). The number of avoided hip fractures during the six-year post-intervention period was estimated to 14 (0.44 per 1,000 person-years). The Markov model estimated a difference in societal costs between an individual that experiences a first year hip fracture and an individual that avoids a first year hip fracture ranging from 280,000 to 550,000 SEK, and between 1.1 and 3.2 QALYs (quality-adjusted life-years, discounted 3%), for males and females aged 65-79 years and 80+ years. The cost-effectiveness analysis resulted in zero net costs and a gain of 35 QALYs, and the do-nothing alternative was thus dominated. CONCLUSIONS: The community-based elderly safety promotion program aiming at preventing accidental falls seems as cost-effective as osteoporosis pharmaceuticals.<p /> <p>Language: en</p>",
language="en",
issn="1478-7547",
doi="10.1186/1478-7547-6-11",
url="http://dx.doi.org/10.1186/1478-7547-6-11"
}