Systematic review and critical methodological appraisal of community-based falls prevention economic models

Kwon, Joseph; Squires, Hazel; Franklin, Matthew; Young, Tracey

doi:10.1186/s12962-022-00367-y

Cost Effectiveness and Resource Allocation

Table 1 Overview of included decision models for critical appraisal

From: Systematic review and critical methodological appraisal of community-based falls prevention economic models

#	References	Target population	Type of analysis/perspective	Intervention [type] (# of forms)	Model type/time horizon
1	Agartioglu et al. [144]	Fallers aged 65+ admitted to A&E	CEA/PS	HAM	DT/1 year
2	Albert et al. [145]	CD aged 50+ (mean age 75.5)	CUA/PS	MF int.	DT/1 year
3	Alhambra-Borras et al. [146]	CD aged 65+ at high falls risk or frail with no severe physical or cognitive limitation	CUA/PS	Exercise	Markov cohort/lifetime
4	Beard et al. [103]	CD aged 60+	CBA; ROI/PS; Soc	Intersectoral (MC) int.^a	BD^b/5 years
5	Boyd et al. [109]	Aged 65+	CUA/PS	Cataract surgery	Markov cohort/20 years
6	Carande-Kulis et al. [97]	CD aged 65+	ROI/US private health insurance	Exercise (2); MC int.	BD/1 year
7	CSP [96]	CD aged 65+	ROI/PS	FRS + exercise [PT]	DT/1 year
8	Church et al. [89]	CD and residential care, aged 65+	CEA; CUA/PS	Exercise (3); MC int.; MF int.; MRA; cataract surgery; Med. mod.; cardiac pacing	Markov cohort/10 years
9	Church et al. [90]	CD aged 65+	CEA; CUA/PS	Exercise (4); MC int.; MF int. (2); MRA; HAM; cataract surgery; Med. mod.; cardiac pacing	Markov cohort/lifetime
10	Comans et al. [105]	CD aged 65+, falls history or gait/functional decline, cognitively intact	ROI/Soc	MF int. (2)	BD/1 year
11	Day et al. [104]	CD, characteristics vary by intervention^c	CEA/PS; Soc	Exercise (2); HAM; MF int.; Med. mod.; cardiac pacing	DT/1 year
12	Day et al. [93]	CD aged 70+	CEA/PS; Soc	Exercise [Tai Chi]	DT/1 year
13	Deverall et al. [94]	CD aged 65+	CUA/PS; Soc	Exercise (3)	Markov cohort/25 years
14	Eldridge et al. [115]	Aged 65+, CD or nursing home	CUA/PS	FRS + MF int. or exercise	DT + Markov cohort/lifetime
15	Farag et al. [91]	CD aged 65+, no falls history	CUA/PS	Non-specific int.	Markov cohort/lifetime
16	Franklin et al. [92]	CD aged 65+	CUA/PS	FRS + exercise (3) or HAM	DT + Markov cohort/2 years
17	Frick et al. [86]	CD aged 65+	CUA/US healthcare payer^d	Exercise (2); HAM; MF int. (2); Med. mod.; Vit. D	BD/1 year^e
18	Hektoen et al. [98]	CD women aged 80+	CEA/Soc	Exercise	BD/1 year
19	Hiligsmann et al. [101]	Aged 60+ with osteoporosis	CUA/Soc	Vit. D and calcium	Markov patient/lifetime
20	Hirst et al. [123]	Women 75+ on pain medication	CUA/PS	Med. mod.	Markov patient/1 year
21	Honkanen et al. [119]	Adults aged 65+, CD at baseline	CUA; ROI/Soc	Hip protectors	Markov cohort/lifetime
22	Howland et al. [87]	CD aged 65+, fall admitted to A&E	ROI/US healthcare payer^d	MC int	BD/1 year
23	Ippoliti et al. [112]	CD aged 65+, mountainous areas	ROI/PS	MF int.	BD/3 years
24	Johansson et al. [107]	CD aged 65+	CUA/Soc	Intersectoral (MC) int.^f	Markov cohort/lifetime
25	Lee et al. [147]	CD aged 65–80, no falls history	CBA/PS	Vit. D [targeted vs. universal]	DT + Markov cohort/3 years
26	Ling et al. [88]	CD aged 65+, falls history/risk factors	ROI/US healthcare payer^d	HAM	BD/1 year
27	McLean et al. [148]	CD aged 70+	CEA; CUA/PS	Exercise	DT/18 months
28	Miller et al. [106]	CD aged 50+ at high falls risk	ROI/US healthcare^d; Soc	MC int.	BD/2 years
29	Mori et al. [95]	CD women 65+, no osteoporotic fracture	CUA/Soc	Exercise [alone or with bisphosphonate]	DT + Markov patient/lifetime
30	Moriarty et al. [120]	CD aged 65, no adverse events from benzodiazepine/PPI	CUA/PS	Med. mod.	DT + Markov patient/35 years
31	Nshimyu-mukiza et al. [113]	Women aged 40+ (subgroup 65+)	CEA; CUA/PS	Fracture risk screening + physical activity, Vit. D and calcium, and/or Osteoporosis screening and treatment	DT + Markov patient/lifetime
32	OMAS [114]	CD aged 65+	CEA; ROI/PS	Exercise; HAM; Vit. D and calcium; Med. mod.; gait-stabilizer	Markov cohort/lifetime
33	Pega et al. [111]	CD aged 65+	CUA/PS	HAM	Markov cohort/lifetime
34	Poole et al. [149]	Aged 65+	ROI/PS	Vit. D	BD/1 year
35	Poole et al. [150]	CD aged 60+	CUA; ROI/PS	Vit. D	Markov cohort/5 years
36	PHE [116]	CD aged 65+	CUA; ROI/PS	Exercise (3); HAM	DT/2 years
37	RCN [84]	CD aged 60+	CUA/PS	Exercise; MF int.	Markov cohort/lifetime
38	Sach et al. [99]	Women 70+, bilateral cataracts	CEA; CUA/PS; Soc	Cataract surgery [first eye]	BD/lifetime extrapol.^g
39	Sach et al. [100]	Women 70+, second operable cataract	CUA/PS; Soc	Cataract surgery [second eye]	BD/lifetime extrapol.^g
40	Smith et al. [85]	Aged 65+ covered by GP and hospital	ROI/PS	FRS + MF int	Risk prediction/1 year
41	Tannenbaum et al. [121]	CD aged 65+ and insomnia	CUA/PS	Med. mod.; CBT	Markov cohort/5 years
42	Turner et al. [124]	CD aged 65+ chronic sedative use for insomnia	CUA/PS	Med. mod.	DT + Markov cohort/1 year
43	van der Velde et al. [151]	CD geriatric outpatients with falls history	CEA/PS	Med. mod.	BD/1 year^e
44	Wilson et al. [110]	CD aged 65+	CUA/PS	HAM	Markov cohort/lifetime
45	Wu et al. [102]	CD Medicare beneficiaries aged 65+ and falls history	CEA; ROI/PS; Soc	MF int.	BD/1 year
46	Zarca et al. [122]	Aged 65+ without previous hip fracture	CEA; CUA/PS	Vit. D (targeted in two ways vs. universal)	DT + Markov patient/lifetime

BD binary decision (model), CBA cost–benefit analysis, CBT cognitive behavioural therapy, CD community-dwelling, CEA cost-effectiveness analysis, CSP Chartered Society of Physiotherapy, CUA cost-utility analysis, DT decision tree, Exp. Expedited, FRS falls risk screening, HAM home assessment and modification, Int. intervention, Med. mod. medication modification, MC multiple-component, MF multifactorial, MRA multifactorial risk assessment only, OMAS Ontario Medical Advisory Secretariat, PHE Public Health England, PPI proton pump inhibitor, PS public sector, PT physiotherapy, RCN Royal College of Nursing, ROI return on investment analysis, Soc societal
^aIncluded individually tailored education, HAM and exercise and public space safety improvement
^bBinary decision models include two scenarios, with or without intervention, and no time-based cycles or probability trees
^cCardiac pacing targeted population aged 50+ due to high falls risk. Other interventions targeted populations aged 65+
^dThis would include public Medicare/aid, private health insurance and patients
^e1-year horizon with lifetime costs of falls
^fIncluded individually tailored education, group balance exercises, Tai Chi, other physical activities and HAM, neighbourhood hazard removal and housing reconstruction
^g1-year trial outcomes are extrapolated over lifetime horizon

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