Cost effectiveness of fall prevention programmes for older adults

The worldwide prevalence of falls is 5186 per 100 000 people (James et al, 2020) and is one of the leading causes of injury for older adults (Berková and Berka, 2018). Falls are associated with a substantial increase in risk of mortality (McMahon et al, 2012) and are the second leading cause of unintentional death worldwide (WHO, 2021). A single fall can lead to reduced social participation (Pin and Spini, 2016), functional capacity (Laybourne et al, 2008) and self-confidence (Schoene et al, 2019). These broad impacts can lead to disability and long-term stays in nursing homes (McMahon et al, 2012).

As well as the individual impact, falls in older adults represent a substantial burden to the NHS. Between April 2020 and March 2021, the rate of fall-related emergency admissions in England for adults over 65 years was 2023 per 100 000 people (Public Health England, 2021). Injuries by falls account for over 4 million hospital bed days in England alone, and cost the NHS around £2.3 billion each year (Treml et al, 2010; National Institute for Health and Care Excellence (NICE), 2013a). Owing to this substantial individual burden and the subsequent financial ramifications, there is a need to identify interventions that are not just successful at reducing the risk of falls, but also cost-effective. This need forms part of a wider healthcare resource allocation decision-making process that balances healthcare systems’ limited resources, individual and collective health-related priorities, and the importance of cost-effectiveness evidence in facilitating the future roll out of the interventions. Previous reviews in this area have identified that exercise fall prevention programmes for older people are effective in reducing the rate of falls (Palmer et al, 2020).