Costs and benefits of multifactorial falls prevention in nursing homes in the Netherlands

Abstract

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.

Keywords: Accidental falls; Cost-benefit analyses; Long-term care; Multifactorial prevention; Nursing home.