G2TT
来源类型Research Reports
规范类型报告
DOIhttps://doi.org/10.7249/RR1649
ISBN9780833096623
来源IDRR-1649-ASPEC
Evaluation of an Intervention to Prevent Falls
Daniel A. Waxman; Xiaoyu Nie; Asa Wilks; David A. Ganz
发表日期2016
出版年2016
页码66
语种英语
结论

The Intervention Did Not Substantially Affect Costs

  • No statistically significant effect on costs was detected.
  • The 95-percent confidence interval for the intervention's effect on total monthly Medicare costs ranged from a $94-per-month decrease to a $130-per-month increase.
  • The 95-percent confidence interval for the intervention's effect on direct injury–related Medicare costs ranged from a $12-per-month decrease to a $48-per-month increase.

Researchers Did Not Detect an Effect on the Frequency of ED Visits for Fall-Related Injuries

  • No statistically significant effect on fall-related ED visits was detected.
  • The 95-percent confidence interval for the estimated effect of the intervention on the incidence of fall-related injuries leading to ED visits ranged from a 26-percent reduction to a 43-percent increase (i.e., an incidence rate ratio of 0.74 to 1.43). The wide range of this estimate suggests that the study was underpowered for this outcome and that a clinically meaningful effect could have gone undetected.

Researchers Developed and Validated a Model That Can Be Used to Measure the Incidence of Fall-Related ED Visits Without Relying on External Cause-of-Injury Codes

  • The model assigns each ED visit a probability weight that represents the likelihood that the visit was precipitated by a fall.
  • The weights can be summed to measure the incidence of fall in a given population and time interval. They can also be used to determine the incidence of particular fall-related injuries of interest by summing the weights for ED visits during which particular injuries were diagnosed.
摘要
  • For future evaluations of interventions aimed at preventing fall-related injuries, study outcomes derived from Medicare claims offer several advantages over self-reported data. Their primary disadvantage is that, at present, claims are available only for beneficiaries enrolled in fee-for-service Medicare. Advantages of claims-based outcomes include that they are not subject to recall bias, they allow for measurement of baseline differences in costs or the incidence of fall-related injuries, and they allow for intention-to-treat analyses. Because claims-based outcomes can be measured without costly follow-up calls, such outcomes might facilitate larger-scale studies of population-based interventions.
  • When the goal is to use health care claims as a surrogate for measuring whether or not a fall-related injury occurred, either direct injury-related costs or the estimated rate of falls might be better measures than total costs.
  • Cost-effectiveness analyses that consider not only health care costs but also improvements in health could be an important step in understanding the value of these interventions.
主题The Elderly ; Geriatrics ; Health Care Program Evaluation ; Medicare ; Preventive Health Care
URLhttps://www.rand.org/pubs/research_reports/RR1649.html
来源智库RAND Corporation (United States)
引用统计
资源类型智库出版物
条目标识符http://119.78.100.153/handle/2XGU8XDN/108361
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GB/T 7714
Daniel A. Waxman,Xiaoyu Nie,Asa Wilks,et al. Evaluation of an Intervention to Prevent Falls. 2016.
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