This economic evaluation was based on a single clinical study. The time horizon of the analysis was 12 months. The authors stated that a societal perspective was adopted in the study.
The clinical data were derived from a randomised clinical trial (RCT) that enrolled 333 patients (166 in the intervention group and 167 in the control group) who were followed for a 12-month period. Blinding was performed. The two groups were comparable at baseline in terms of their demographic characteristics and quality of life.
Monetary benefit and utility valuations:
Utility valuations were derived from the sample of patients enrolled in the RCT using the EuroQol (EQ-5D) questionnaires administered at baseline and after 4 and 12 months. An alternative source of utility valuations, the Falls Handicap Inventory, was also used.
Measure of benefit:
The two main health benefit measures used were the proportion of individuals sustaining a fall during the follow-up period and quality-adjusted life-years (QALYs).
The three main cost categories considered were programme costs (professionals’ time), other health care costs and patient/family costs (home modifications and out-of-pocket expenses). The other health care costs included general practitioner consultations or home visits, inpatient and outpatient specialist care, hospital admissions, admissions to nursing homes or homes for the elderly, paramedics consultations, alternative medicine, aids and other devices, professional home care and medications. Resource use was estimated through cost diaries, which were collected by monthly telephone interviews with all participants in the RCT. These resources were valued using standardised cost prices from the Dutch manual for cost analysis in health care research. The costs were in euros (EUR). The price year was 2004. No discounting was performed because of the short time horizon. An imputation method was used for missing data.
Analysis of uncertainty:
The uncertainty surrounding the cost-effectiveness estimates was investigated through bootstrapping. A one-way sensitivity analysis was also performed in order to test the robustness of some base-case assumptions.