Objective-To assess the incremental costs and cost effectiveness of impleme
nting a home based muscle strengthening and balance retraining programme th
at reduced falls and injuries in older women.
Design-An economic evaluation carried out within a randomised controlled tr
ial with two years of follow up. Participants were individually prescribed
an exercise programme (exercise group, n=116) or received usual care and so
cial visits (control group, n=117).
Setting-17 general practices in Dunedin, New Zealand.
Participants-Women aged 80 years and older living in the community and invi
ted by their general practitioner to take part.
Main outcome measures-Number of falls and injuries related to falls, costs
of implementing the intervention, healthcare service costs resulting from f
alls and total healthcare service costs during the trial. Cost effectivenes
s was measured as the incremental cost of implementing the exercise program
me per fall event prevented.
Main results-27% of total hospital costs during the trial were related to f
alls. However, there were no significant differences in health service cost
s between the two groups. Implementing the exercise programme for one and t
wo years respectively cost $314 and $265 (1995 New Zealand dollars) per fal
l prevented, and $457 and $426 per fall resulting in a moderate or serious
Conclusions-The costs resulting from falls make up a substantial proportion
of the hospital costs for older people. Despite a reduction in falls as a
result of this home exercise programme there was no significant reduction i
n healthcare costs. However, the results reported will provide information
on the cost effectiveness of th, programme for those making decisions on fa
lls prevention strategies.