An economic evaluation of the SUNBEAM programme: a falls-prevention randomized controlled trial in residential aged care

Hewitt, J; Saing, S; Goodall, S; Henwood, T; Clemson, L; Refshauge, K

An economic evaluation of the SUNBEAM programme: a falls-prevention randomized controlled trial in residential aged care

Hewitt, J Saing, S

Goodall, S

Henwood, T Clemson, L Refshauge, K

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Publication Type:: Journal Article
Citation:: Clinical Rehabilitation, 2019, 33 (3), pp. 524 - 534
Issue Date:: 2019-03-01

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Field	Value	Language
dc.contributor.author	Hewitt, J	en_US
dc.contributor.author	Saing, S https://orcid.org/0000-0001-5913-9654	en_US
dc.contributor.author	Goodall, S https://orcid.org/0000-0001-6611-6565	en_US
dc.contributor.author	Henwood, T	en_US
dc.contributor.author	Clemson, L	en_US
dc.contributor.author	Refshauge, K	en_US
dc.date.issued	2019-03-01	en_US
dc.identifier.citation	Clinical Rehabilitation, 2019, 33 (3), pp. 524 - 534	en_US
dc.identifier.issn	0269-2155	en_US
dc.identifier.uri	http://hdl.handle.net/10453/134861
dc.description.abstract	© The Author(s) 2018. Objective: To estimate the cost-effectiveness of a strength and balance exercise programme (SUNBEAM) which has been shown to be clinically effective in reducing the rate of falls in residents of aged care facilities. Design: An economic evaluation was conducted alongside a pragmatic cluster randomized controlled trial that included 16 residential care facilities and 221 participants. Mean participant age was 86 years, 65% were female and 78% relied on a mobility aide. A cost-effectiveness analysis examined the costs of providing the exercise programme and costs of health service use arising from falls in each arm (intervention and usual care) over 12 months. Main measures: Incremental cost-effectiveness ratios were calculated for the cost per fall avoided. Costs were bootstrapped to obtain adjusted confidence intervals for the incremental cost-effectiveness ratios. Results: Of 63 facilities contacted, 16 met the eligibility criteria and were randomized to the intervention or usual care (1:1). There were 142 falls in the intervention group and 277 in the usual care group. 72 injurious falls occurred in the intervention group versus 157 with usual care. Delivery of the SUNBEAM programme cost $463 per participant. The mean total cost of each fall (regardless of group) was $400.09 and the mean cost of each injurious fall was $708.27. The incremental cost-effectiveness ratio was $22 per fall per person avoided with the mean bootstrapped incremental cost-effectiveness ratio $18 per fall avoided (95% CI: −$380.34 to $417.85). Conclusion: The SUNBEAM programme can be considered cost-effective, relative to other fall-prevention interventions in older adults.	en_US
dc.relation.ispartof	Clinical Rehabilitation	en_US
dc.relation.isbasedon	10.1177/0269215518808051	en_US
dc.subject.classification	Rehabilitation	en_US
dc.subject.mesh	Humans	en_US
dc.subject.mesh	Exercise Therapy	en_US
dc.subject.mesh	Program Evaluation	en_US
dc.subject.mesh	Accidental Falls	en_US
dc.subject.mesh	Aged, 80 and over	en_US
dc.subject.mesh	Residential Facilities	en_US
dc.subject.mesh	Preventive Health Services	en_US
dc.subject.mesh	Cost-Benefit Analysis	en_US
dc.subject.mesh	Australia	en_US
dc.subject.mesh	Female	en_US
dc.subject.mesh	Male	en_US
dc.title	An economic evaluation of the SUNBEAM programme: a falls-prevention randomized controlled trial in residential aged care	en_US
dc.type	Journal Article
utslib.citation.volume	3	en_US
utslib.citation.volume	33	en_US
utslib.for	1117 Public Health and Health Services	en_US
utslib.for	11 Medical and Health Sciences	en_US
pubs.embargo.period	Not known	en_US
pubs.organisational-group	/University of Technology Sydney
pubs.organisational-group	/University of Technology Sydney/Faculty of Business
pubs.organisational-group	/University of Technology Sydney/Strength - CHERE - Centre for Health Economics Research and Evaluation
utslib.copyright.status	closed_access
pubs.issue	3	en_US
pubs.publication-status	Published	en_US
pubs.volume	33	en_US

Abstract:

© The Author(s) 2018. Objective: To estimate the cost-effectiveness of a strength and balance exercise programme (SUNBEAM) which has been shown to be clinically effective in reducing the rate of falls in residents of aged care facilities. Design: An economic evaluation was conducted alongside a pragmatic cluster randomized controlled trial that included 16 residential care facilities and 221 participants. Mean participant age was 86 years, 65% were female and 78% relied on a mobility aide. A cost-effectiveness analysis examined the costs of providing the exercise programme and costs of health service use arising from falls in each arm (intervention and usual care) over 12 months. Main measures: Incremental cost-effectiveness ratios were calculated for the cost per fall avoided. Costs were bootstrapped to obtain adjusted confidence intervals for the incremental cost-effectiveness ratios. Results: Of 63 facilities contacted, 16 met the eligibility criteria and were randomized to the intervention or usual care (1:1). There were 142 falls in the intervention group and 277 in the usual care group. 72 injurious falls occurred in the intervention group versus 157 with usual care. Delivery of the SUNBEAM programme cost $463 per participant. The mean total cost of each fall (regardless of group) was $400.09 and the mean cost of each injurious fall was $708.27. The incremental cost-effectiveness ratio was $22 per fall per person avoided with the mean bootstrapped incremental cost-effectiveness ratio $18 per fall avoided (95% CI: −$380.34 to $417.85). Conclusion: The SUNBEAM programme can be considered cost-effective, relative to other fall-prevention interventions in older adults.

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http://hdl.handle.net/10453/134861