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新南威尔士州社区及住宿式老年护理跌倒预防策略的经济评估

An economic evaluation of community and residential aged care falls prevention strategies in NSW.

作者信息

Church Jody, Goodall Stephen, Norman Richard, Haas Marion

机构信息

Centre for Health Economics Research and Evaluation, University of Technology, Sydney, Australia.

出版信息

N S W Public Health Bull. 2011 Jun;22(3-4):60-8. doi: 10.1071/NB10051.

Abstract

AIM

To evaluate the cost-effectiveness of strategies designed to prevent falls amongst people aged 65 years and over living in the community and in residential aged-care facilities.

METHODS

A systematic review and meta-analysis of the literature was conducted. The pooled fall rate ratio was used in a decision analytic model that combined a Markov model and decision tree to estimate the costs and outcomes of potential interventions and/or strategies. The resulting cost per quality-adjusted life year was estimated.

RESULTS

The most cost-effective falls prevention strategy in community-dwelling older people was Tai Chi. Expedited cataract surgery and psychotropic medication withdrawal were also found to be cost-effective; however, the effectiveness of these interventions is less certain due to small numbers of trials and participants. The most cost-effective falls prevention strategies in residential aged-care facilities were medication review and vitamin D supplementation.

摘要

目的

评估旨在预防社区及老年护理机构中65岁及以上人群跌倒的策略的成本效益。

方法

对文献进行系统综述和荟萃分析。将汇总的跌倒发生率比值用于一个决策分析模型,该模型结合了马尔可夫模型和决策树,以估计潜在干预措施和/或策略的成本和结果。估算得出每质量调整生命年的成本。

结果

在社区居住的老年人中,最具成本效益的跌倒预防策略是太极拳。快速白内障手术和停用精神药物也被证明具有成本效益;然而,由于试验和参与者数量较少,这些干预措施的有效性不太确定。在老年护理机构中,最具成本效益的跌倒预防策略是药物审查和补充维生素D。

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