https://publichealthmatters.blog.gov.uk/2018/02/19/helping-local-areas-to-prevent-falls-in-older-people/

Helping local areas to prevent falls in older people

We have previously written about the focus that Public Health England is putting on making the economic case for prevention and this is manifesting itself practically through the development of a series of Return on Investment (RoI) Tools for locals authorities to make sure that every pound of their budget has the maximum impact.

ROI tools bring together the best available evidence on costs, savings, and health benefits in a single place. You can use them to estimate the value of investing in early diagnosis and prevention in your area.

Impact of falls

The latest tool that we have released is on falls prevention. Falls are very common and can have serious implications for the health of older people, with around a third of people aged 65 and over experiencing a fall each year, increasing to half of those aged 80 and over.

In around 5% of cases a fall leads to fracture and hospitalisation, which is costly for health services and the wider economy as well as having a detrimental impact on the health and independence of the individual.

There are around 255,000 falls-related emergency hospital admissions in England among patients aged 65 and over each year, and it is estimated that fragility fractures cost the UK around £4.4 billion, of which 25% is for social care.

So preventing falls is therefore important for helping to maintain the independence and wellbeing of older people and their carers, as well as our health and social care services.

How does the tool work?

This tool will help to assess return on investment for  a number of falls prevention interventions for older people where there was supporting evidence around both clinical and cost-effectiveness.  People involved in local policy setting and commissioning as well as those delivering falls programmes in local government can use the tool to report the RoI for a number of interventions to support investment in falls in their area.

The tool allows the user to select one of the four interventions (outlined below) and input information specific to their area to calculate the RoI.

Interventions:

  • Otago strength and balance programme
  • Group exercise  (FaME)
  • Tai Chi or Tai Ji Quan
  • Home assessment and modification (HAM) – aimed at those who have experienced a fall related injury  and so viewed as a secondary prevention intervention.

Some falls prevention interventions have not been included in the tool, because there was not sufficient clinical and / or cost-effectiveness evidence needed to support a RoI analysis.

Findings 

On a national level some of the main findings from the tool are:

  • Every £1 spent on the Home assessment and modification intervention, saves around £3.17 on health care and social care costs
  • Two of the interventions; Otago Strength and Balance and Falls Management Exercise (FaME) virtually achieve financial breakeven – in other words they fall just short of saving as much as they cost to deliver with RoI of £0.95 and £0.99 respectively
  • When the quality and quantity of life is considered, all interventions have a positive return on investment:
    • Every £1 spent on the Home assessment and modification intervention, results in benefits of around £7.34 in terms of health/ social care savings and quality of life gains
    • Every £1 spent on the Falls Management Exercise (FaME) intervention, results in benefits of around £2.28 in terms of health/ social care savings and quality of life gains
    • Every £1 spent on the Otago Strength and Balance intervention, results in benefits of around £2.20 in terms of health/ social care savings and quality of life gains
    • Every £1 spent on the Tai Chi intervention, results in benefits of around £1.97 in terms of health/ social care savings and quality of life gains

Existing RoI work

This is the latest Return on Investment tool to be published by PHE, our previously published tools include:

The health economics evidence resources (HEER), which was published back in September, collects and summarises the economic evidence on a wide selection of public health interventions. Each piece of evidence is categorised against over 20 criteria allowing you to filter and select only what you are interested in. The HEER replaces the previously published menu of preventative interventions.

Further information

For any questions about the Falls prevention RoI tool, or any other work being undertaken by PHE on health economics and return on investment in public health, email healtheconomics@phe.gov.uk

You can also sign up to our half hour webinar on the tool, taking place on Thursday 1 March at 11am by emailing healtheconomics@phe.gov.uk to register your interest.

1 comment

  1. Comment by Derek Twigg posted on

    Falls prevention sessions are run by the Fire Service in association with the NHS. The sessions are free and were set up with the sure knowledge that they would be cost effective. Less falls lead to lower calls to GPs and/or the emergency services. The big cost saving is in reduced need for surgery and subsequent hospital bed occupancy.
    The two hour course sessions comprise lectures on healthy eating and drinking, do's and dont's on how to lay out the home, mobility exercises and, most important of all, getting onto the floor and then getting up to a standing position. The getting up can be by using a persons own strength and flexibility or by crawling to a chair or piece of furniture and climbing up it.
    The demonstration and action of recovering from a simulated fall is a great confidence builder and persuades each member of the course that, unless they are badly injured, they do not need to stay on the floor until discovered.

    Reply

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