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Fall-related health service utilizat...

Bray Jenkyn, Krista M.

Fall-related health service utilization, costs, and cost-effectiveness of a multi-factorial falls prevention program delivered to community-dwelling older adults.

紀錄類型:	書目-電子資源 : 單行本
正題名/作者:	Fall-related health service utilization, costs, and cost-effectiveness of a multi-factorial falls prevention program delivered to community-dwelling older adults./
作者:	Bray Jenkyn, Krista M.
面頁冊數:	244 p.
附註:	Source: Dissertation Abstracts International, Volume: 70-12, Section: B, page: 7468.
Contained By:	Dissertation Abstracts International70-12B.
標題:	Gerontology. -
電子資源:	http://pqdd.sinica.edu.tw/twdaoapp/servlet/advanced?query=NR54271
ISBN:	9780494542712

Fall-related health service utilization, costs, and cost-effectiveness of a multi-factorial falls prevention program delivered to community-dwelling older adults.
Bray Jenkyn, Krista M.

Fall-related health service utilization, costs, and cost-effectiveness of a multi-factorial falls prevention program delivered to community-dwelling older adults. - 244 p.

Source: Dissertation Abstracts International, Volume: 70-12, Section: B, page: 7468.

Thesis (Ph.D.)--The University of Western Ontario (Canada), 2009.

The purpose of this dissertation was to add to the understanding of falls and fall-related health service utilization, and to quantify the costs and the cost-effectiveness of multi-factorial falls prevention in community-dwelling older adults. The specific aims were (1) to provide a systematic and methodological review of the literature on the cost-effectiveness of falls prevention, (2) to determine the relationship between fall-event characteristics and subsequent fall-related health service utilization, and (3) to evaluate the costs and cost-effectiveness of a falls prevention program delivered to community dwelling older veterans and their caregivers. In order to achieve these aims, several related activities were completed. The first was to create and evaluate a brief interview tool to capture self-reported health service utilization among participants enrolled in the multi-factorial falls prevention intervention. The second was to use a novel method to perform the cost-effectiveness analysis using the net-benefit regression framework. This allowed the observed cost-effectiveness of the program to be evaluated across several important subgroups that might otherwise have gone unidentified.

ISBN: 9780494542712Subjects--Topical Terms:

168436
Gerontology.

Fall-related health service utilization, costs, and cost-effectiveness of a multi-factorial falls prevention program delivered to community-dwelling older adults.
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245 1 0 $a Fall-related health service utilization, costs, and cost-effectiveness of a multi-factorial falls prevention program delivered to community-dwelling older adults.
300 $a 244 p.
500 $a Source: Dissertation Abstracts International, Volume: 70-12, Section: B, page: 7468.
502 $a Thesis (Ph.D.)--The University of Western Ontario (Canada), 2009.
520 $a The purpose of this dissertation was to add to the understanding of falls and fall-related health service utilization, and to quantify the costs and the cost-effectiveness of multi-factorial falls prevention in community-dwelling older adults. The specific aims were (1) to provide a systematic and methodological review of the literature on the cost-effectiveness of falls prevention, (2) to determine the relationship between fall-event characteristics and subsequent fall-related health service utilization, and (3) to evaluate the costs and cost-effectiveness of a falls prevention program delivered to community dwelling older veterans and their caregivers. In order to achieve these aims, several related activities were completed. The first was to create and evaluate a brief interview tool to capture self-reported health service utilization among participants enrolled in the multi-factorial falls prevention intervention. The second was to use a novel method to perform the cost-effectiveness analysis using the net-benefit regression framework. This allowed the observed cost-effectiveness of the program to be evaluated across several important subgroups that might otherwise have gone unidentified.
520 $a The main data source for this dissertation research came from the Project to Prevent Falls in Veterans. The trial evaluated the effectiveness of preventing falls through risk factor screening and referral to appropriate, but existing, health care services for modification. For this dissertation, multiple logistic regression analyses were conducted to assess the relationship between fall-event characteristics and subsequent fall-related health service use. A systematic review and methodological critique of the cost-effectiveness and falls prevention literature was completed to uncover whether certain important subgroups may be more cost-effective than others. Cost and cost-effectiveness analyses were undertaken to provide significant first-estimates of the costs and consequences of implementing multi-factorial falls prevention using Specialized Geriatric Services within Canada's publicly funded health care system.
520 $a The results of this dissertation research suggest that seniors, family members and clinicians should be aware of the association between fall-event characteristics (i.e. falls that occur in the evening and night time, those that occur while the faller is not using a walking aid, falls that result in assistance being required to get up, and those falls that result in injury) and subsequent fall-related health service use. Fall prevention programs directed only at older seniors aged 80 years and older, at those with a history of falls, at those with severe visual impairment and at participants with four or more potentially modifiable risk factors for falls are more cost-effective (i.e. result in a lower cost per additional fall prevented) than programs directed at all seniors 65 years and older. A low intensity multi-factorial falls prevention approach using specialized geriatric assessments with referral to existing resources was not shown to be cost-effective compared to usual care. Finally, the possibility of regional differences should be considered with future evaluations of falls prevention programs implemented in south-western Ontario.
520 $a Keywords. accidental falls, multi-factorial falls prevention, fall-related health service utilization, costs, cost-effectiveness, incremental cost-effectiveness ratio (ICER), net-benefit regression framework (NBRF), older adults, community-dwelling, veterans, measurement, reliability, multivariable regression models.
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