International Journal of Technology Assessment in Health Care


Cost-effectiveness of a multidisciplinary fall prevention program in community-dwelling elderly people: A randomized controlled trial (ISRCTN 64716113)

Marike R. C. Hendriksa1, Silvia M. A. A. Eversa1, Michel H. C. Bleijlevensa1, Jolanda C. M. van Haastregta1, Harry F. J. M. Creboldera1 and Jacques Th. M. van Eijka1

a1 Maastricht University


Objectives: Multidisciplinary and multifactorial interventions seem to be effective in preventing falls. We aimed to assess the cost-effectiveness of a multidisciplinary fall prevention program compared with usual Dutch healthcare in community-dwelling people 65 years of age or older who experienced a fall.

Methods: Cost-effectiveness and cost-utility analysis were performed from a societal perspective. Falls and healthcare utilization were continuously measured for 12 months. Daily functioning and quality of life were measured at baseline, after 4 and 12 months. Bootstrap analyses were performed to estimate uncertainty of the findings and sensitivity analysis to assess the generalizability of assumptions made.

Results: One hundred sixty-six participants were randomly allocated to the experimental group and 167 to the control group. The overall response rate was 74 percent. Healthcare and patient and family costs of both groups were comparable. Our analyses showed no effect of the intervention program on falls, daily functioning, or quality of life measures.

Conclusions: The multidisciplinary intervention program to prevent falls was not cost-effective compared with usual care in the Netherlands. Notwithstanding our findings, however, falls still have an important impact on society and individuals in terms of costs and effects. Economic evaluations studying promising interventions to prevent falls, therefore, remain necessary.


Preliminary results of this cost-effectiveness analysis were presented at the 5th Annual Meeting of the Gerontological Society of America, Dallas, Texas, November 2006. The full paper was presented at the International Health Economics Association (IHEA) Sixth World Congress: Explorations In Health Economics, Copenhagen, Denmark, July 2007. The study was funded by The Netherlands Organization for Health Research and Development (ZonMw), Committee Health Care Efficiency Research Programme, grant number 945-02-053 (P.O. Box 93 245, 2509 AE Den Haag, The Netherlands; Email