Open Access
Cost effectiveness of patient education for the prevention of falls in hospital : economic evaluation from a randomized controlled trial
Terrence Peter Haines,Anne-Marie Hill,Keith D. Hill,Sandra G. Brauer,Tammy Hoffmann,Tammy Hoffmann,Christopher Etherton-Beer,Steven M. McPhail +7 more
TLDR
In this paper, a multimedia patient education program provided with trained health professional follow-up was shown to reduce falls among cognitively intact hospital patients, with a 52% probability the complete program was both more effective and less costly (from the health service perspective) than providing usual care alone.Abstract:
Background
Falls are one of the most frequently occurring adverse events that impact upon the recovery of older hospital inpatients. Falls can threaten both immediate and longer-term health and independence. There is need to identify cost-effective means for preventing falls in hospitals. Hospital-based falls prevention interventions tested in randomized trials have not yet been subjected to economic evaluation.
Methods
Incremental cost-effectiveness analysis was undertaken from the health service provider perspective, over the period of hospitalization (time horizon) using the Australian Dollar (A$) at 2008 values. Analyses were based on data from a randomized trial among n = 1,206 acute and rehabilitation inpatients. Decision tree modeling with three-way sensitivity analyses were conducted using burden of disease estimates developed from trial data and previous research. The intervention was a multimedia patient education program provided with trained health professional follow-up shown to reduce falls among cognitively intact hospital patients.
Results
The short-term cost to a health service of one cognitively intact patient being a faller could be as high as A$14,591 (2008). The education program cost A$526 (2008) to prevent one cognitively intact patient becoming a faller and A$294 (2008) to prevent one fall based on primary trial data. These estimates were unstable due to high variability in the hospital costs accrued by individual patients involved in the trial. There was a 52% probability the complete program was both more effective and less costly (from the health service perspective) than providing usual care alone. Decision tree modeling sensitivity analyses identified that when provided in real life contexts, the program would be both more effective in preventing falls among cognitively intact inpatients and cost saving where the proportion of these patients who would otherwise fall under usual care conditions is at least 4.0%.
Conclusions
This economic evaluation was designed to assist health care providers decide in what circumstances this intervention should be provided. If the proportion of cognitively intact patients falling on a ward under usual care conditions is 4% or greater, then provision of the complete program in addition to usual care will likely both prevent falls and reduce costs for a health service.read more
Citations
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Health Belief Model
TL;DR: This article presents an introduction to the Health Belief Model (HBM), which states that the perception of a personal health behavior threat is influenced by at least three factors: general health values, interest and concern about health; specific beliefs about vulnerability to a particular health threat; and beliefs about the consequences of the health problem.
Journal ArticleDOI
Interventions for preventing falls in older people in care facilities and hospitals
Ian D. Cameron,Lesley D Gillespie,M. Clare Robertson,Geoff R Murray,Keith D. Hill,Robert G. Cumming,Ngaire Kerse +6 more
TL;DR: Assessing the effectiveness of interventions designed to reduce falls by older people in care facilities and hospitals suggested that exercise might reduce falls in people in intermediate level facilities, and increase falls in facilities providing high levels of nursing care.
Journal ArticleDOI
Diurnal cortisol slopes and mental and physical health outcomes: A systematic review and meta-analysis
Emma K. Adam,Meghan E. Quinn,Meghan E. Quinn,Royette Tavernier,Mollie T. McQuillan,Katie A. Dahlke,Kirsten Gilbert +6 more
TL;DR: It is argued that flatter diurnal cortisol slopes may both reflect and contribute to stress-related dysregulation of central and peripheral circadian mechanisms, with corresponding downstream effects on multiple aspects of biology, behavior, and health.
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Physical activity and sedentary behavior in people with major depressive disorder: A systematic review and meta-analysis.
Felipe Barreto Schuch,Davy Vancampfort,Joseph Firth,Simon Rosenbaum,Philip B. Ward,Thaís Reichert,Natália Carvalho Bagatini,Roberta Bgeginski,Brendon Stubbs +8 more
TL;DR: PA and SB are independent predictors of mortality, therefore, future lifestyle interventions targeting both the prevention of SB and adoption and maintenance of PA are warranted.
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Economic burden of stroke: a systematic review on post-stroke care.
S Rajsic,H Gothe,Helena Hiemisch Lobo Borba,Gaby Sroczynski,J Vujicic,Thomas Toell,Uwe Siebert +6 more
TL;DR: Overall PSC costs (inpatient/outpatient) were highest in the USA and lowest in Australia, with rehabilitation services being the main cost driver.
References
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Journal ArticleDOI
A short portable mental status questionnaire for the assessment of organic brain deficit in elderly patients
TL;DR: A 10‐item Short Portable Mental Status Questionnaire (SPMSQ), easily administered by any clinician in the office or in a hospital, has been designed, tested, standardized and validated.
Journal ArticleDOI
Health Belief Model
TL;DR: This article presents an introduction to the Health Belief Model (HBM), which states that the perception of a personal health behavior threat is influenced by at least three factors: general health values, interest and concern about health; specific beliefs about vulnerability to a particular health threat; and beliefs about the consequences of the health problem.
Book
Predicting health behaviour : research and practice with social cognition models
Mark Conner,Paul Norman +1 more
TL;DR: Predicting and Changing Health Behaviour: Future Directions by Paul Norman and Mark Conner and the Author Index Index indicates that the authors believe the current state of health behaviour is likely to change in the coming years.
Journal ArticleDOI
Cost‐effectiveness acceptability curves – facts, fallacies and frequently asked questions
TL;DR: A 'gallery' of CEACs is presented in order to identify the fallacies and illustrate the facts surrounding the CEAC to serve as a reference tool to accompany the increased use ofCEACs within major medical journals.
Reference EntryDOI
Interventions for preventing falls in older people in nursing care facilities and hospitals
Ian D. Cameron,Geoff R Murray,Lesley D Gillespie,M. Clare Robertson,Keith D. Hill,Robert G. Cumming,Ngaire Kerse +6 more
TL;DR: There is evidence that multifactorial interventions reduce falls and risk of falling in hospitals and may do so in nursing care facilities and Vitamin D supplementation is effective in reducing the rate of falls in Nursing care facilities.