Objectives

To investigate whether the implementation of a multifactorial falls intervention in nursing homes is cost-beneficial and alleviates the professional workload.

Design

A comprehensive quantitative model was developed to calculate the impact of investments in multifactorial falls prevention in nursing homes in the Netherlands, comparing the fall incidence using intervention strategies in 1000 nursing home residents with the conditions of usual care over a five-year timeline.

Setting and participants

We built a model combining several data sources regarding falls and injury prevalence in nursing home residents, health care costs, intervention costs and effectiveness, and demographic statistics.

Measures

The primary outcomes were number of falls and injuries, treatment hours and cost.

Results

In the nursing home setting, a baseline scenario was calculated with 1471 falls incidents resulting in 345 injuries per year. The mean cost of injury related treatment and care was calculated 860 thousand euro per year and €4.63 million in five years. Implementing multifactorial intervention over five years, costing 702 thousand euro, resulted in savings in health care costs of €2.0 million, of which €1.6 million was saved in nursing home injury care. The benefits outweighed the costs: each euro invested was compensated by 2.86 euro benefit in total care, 2.31 benefit in nursing home care. Yearly 3050 nursing hours, 3100 paramedical care hours and 760 h of physician care were saved.

Conclusion and implications

Implementation of customized multifactorial interventions provided by multidisciplinary teams is cost-beneficial in reduction of falls in nursing homes. The CBA model gives valuable information about the advantageous consequences (i.e. health benefits, financial benefits and reduced workload of staff) of falls prevention in nursing homes and can provide guidance to the management in structural implementation of multifactorial falls prevention.

中文翻译：

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荷兰养老院预防多因素跌倒的成本和收益

目标

调查在护理院中实施多因素跌倒干预是否有利于成本并减轻专业人员的工作量。

设计

开发了一个综合的定量模型来计算在荷兰养老院中预防多因素跌倒的投资影响，并使用干预策略将1000名疗养院居民的跌倒发生率与五年时间内的常规照护条件进行比较。

设置和参与者

我们建立了一个模型，该模型结合了多个数据源，这些数据源涉及养老院居民跌倒和伤害的发生率，医疗保健成本，干预成本和有效性以及人口统计数据。

措施

主要结果是跌倒和受伤人数，治疗时间和费用。

结果

在疗养院环境中，计算出的基线情景为1471起跌倒事故，每年导致345人受伤。与伤害相关的治疗和护理的平均成本为每年86万欧元，五年内为463万欧元。五年内实施多因素干预，花费了70.2万欧元，节省了200万欧元的医疗保健费用，其中160万欧元节省了护理院的伤害。收益超过成本：每投资1欧元，就可以得到2.86欧元的总体护理费用，2.31欧元的养老院护理费用。每年节省了3050个护理小时，3100个辅助医疗小时和760小时的医生护​​理时间。

结论与意义

由多学科团队提供的定制的多因素干预措施的实施，对于减少养老院的倒塌具有成本效益。CBA模型提供了有关养老院预防跌倒的有利后果（即健康收益，财务收益和减少的工作人员工作量）的有价值的信息，并且可以为管理层预防多因素跌倒的实施提供指导。