@article{ref1,
title="Cost-Effectiveness Analysis of Screening for Risk of In-Hospital Falls Using Physiotherapist Clinical Judgment",
journal="Medical care",
year="2009",
author="Haines, T. and Kuys, Suzanne S. and Morrison, Greg and Clarke, J. and Bew, Paul",
volume="47",
number="4",
pages="448-456",
abstract="INTRODUCTION:: Screening hospital patients for falls risk is now a contentious component of geriatric care despite its widespread clinical use. The economic implications of using a falls risk screening approach to deliver an effective falls prevention intervention have not previously been examined. METHODS:: This was a multicenter prospective longitudinal cohort and incremental cost-effectiveness analysis. PARTICIPANTS/SETTING:: One thousand one hundred twenty-three geriatric inpatients from 17 rehabilitation units across Australia. MEASURES:: Physiotherapist accuracy in predicting patient who will fall was captured with the question &quot;Will this patient experience one or more falls during their rehabilitation period?&quot; Falls were measured using hospital incident reporting systems. PROCEDURE:: The multicenter longitudinal cohort was undertaken to establish the predictive accuracy of physiotherapist clinical judgement. This data was used in the incremental cost-effectiveness analysis where estimates of the cost of falls and effectiveness of an intervention program were taken from previous research. RESULTS:: The accuracy of physiotherapist clinical judgement in predicting falls was high relative to previous research (sensitivity = 0.61, specificity = 0.82, Youden index = 0.43). Selectively providing patient falls-prevention education using physiotherapist clinical judgement would reduce falls [2.2 (SD: 0.19) fallers per 100 inpatients reduction] and reduce resources spent on trying to prevent and treat injuries from in-hospital falls [$2704 AUD (SD: $432) per 100 inpatients reduction] compared with doing nothing. However, there was greater uncertainty as to whether the patient education intervention modeled should be provided selectively or universally. CONCLUSIONS:: Preventing in-hospital falls using a targeted falls prevention intervention approach utilizing physiotherapist clinical judgement was more cost-effective than a &quot;no intervention&quot; approach.<p /> <p>Language: en</p>",
language="en",
issn="0025-7079",
doi="10.1097/MLR.0b013e318190ccc0",
url="http://dx.doi.org/10.1097/MLR.0b013e318190ccc0"
}