Church Jody, Goodall Stephen, Norman Richard, Haas Marion
Centre for Health Economics Research and Evaluation, University of Technology, Sydney, Australia.
N S W Public Health Bull. 2011 Jun;22(3-4):60-8. doi: 10.1071/NB10051.
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.
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.
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.
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。
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。
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。