Community-based falls prevention for older persons: a case study in economic modelling of geriatric public health interventions

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Around one third of people over 65 years fall at least once a year. Falls are known to cause distress, pain, injury, loss of confidence, loss of independence and mortality. Falls are often preventable and local commissioners need to make decisions on the provision of falls prevention strategies based on current, recommendations and alternative prevision.

This study built a complex health economic model based on information from local stakeholders, elderly people, and a systematic review of the literature to compare 22 alternative intervention strategies. Current UK recommended falls prevention strategy had a 93% probability of being cost-effective compared with usual care. However, the optimal strategy was a capacity-constrained version of UK guidelines supplemented with targeted screening of socially vulnerable subgroups. The PhD research demonstrated that complex economic modelling could inform economic evaluation of diverse geriatric public health interventions and integration of diverse geriatric policies, including wider welfare policies and community mobilisation

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