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社区跌倒预防服务对跌倒后呼叫急救车的人群:一项随机对照试验的经济学评价。

Community falls prevention for people who call an emergency ambulance after a fall: an economic evaluation alongside a randomised controlled trial.

机构信息

Health Economics Group, Norwich Medical School, University of East Anglia, Norwich Research Park, Norwich NR4 7TJ, UK.

出版信息

Age Ageing. 2012 Sep;41(5):635-41. doi: 10.1093/ageing/afs071. Epub 2012 Jun 13.

Abstract

OBJECTIVE

we estimated the cost-effectiveness of a community falls prevention service compared with usual care from a National Health Service and personal social services perspective over the 12 month trial period.

DESIGN

a cost-effectiveness and cost utility analysis alongside a randomised controlled trial

SETTING

community.

PARTICIPANTS

people over 60 years of age living at home or in residential care who had fallen and called an emergency ambulance but were not taken to hospital.

INTERVENTIONS

referral to community fall prevention services or usual health and social care.

MEASUREMENTS

incremental cost per fall prevented and incremental cost per Quality-Adjusted Life Years (QALYs)

RESULTS

a total of 157 participants (82 interventions and 75 controls) were used to perform the economic evaluation. The mean difference in NHS and personal social service costs between the groups was £-1,551 per patient over 1 year (95% CI: £-5,932 to £2,829) comparing the intervention and control groups. The intervention patients experienced on average 5.34 fewer falls over 12 months (95% CI: -7.06 to -3.62). The mean difference in QALYs was 0.070 (95% CI: -0.010 to 0.150) in favour of the intervention group.

CONCLUSION

the community falls prevention service was estimated to be cost-effective in this high-risk group. Current Controlled Trials ISRCTN67535605. (controlled-trials.com).

摘要

目的

从国民保健服务和个人社会服务的角度,在 12 个月的试验期间内,我们评估了社区防跌倒服务相对于常规护理的成本效益。

设计

一项成本效益和成本效用分析,以及一项随机对照试验。

设置

社区。

参与者

60 岁以上、在家或居住在养老院中居住、跌倒并呼叫紧急救护车但未住院的人。

干预措施

向社区防跌倒服务或常规卫生和社会护理转诊。

测量

每预防一次跌倒的增量成本和每增加一个质量调整生命年(QALY)的增量成本。

结果

共有 157 名参与者(82 名干预组和 75 名对照组)用于进行经济评估。与对照组相比,干预组和对照组之间,1 年内 NHS 和个人社会服务成本的平均差异为每位患者 -1551 英镑(95%置信区间:-5932 至-2829)。干预组患者在 12 个月内平均少发生 5.34 次跌倒(95%置信区间:-7.06 至-3.62)。干预组的 QALY 平均差异为 0.070(95%置信区间:-0.010 至 0.150)。

结论

在这个高风险人群中,社区防跌倒服务被认为具有成本效益。当前对照试验 ISRCTN67535605。(controlled-trials.com)。

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