Age Ageing. 2026 Jun 1;55(6):afag141. doi: 10.1093/ageing/afag141.
ABSTRACT
BACKGROUND: Stopping Elderly Accidents, Deaths, and Injuries (STEADI) Options was a randomized trial of a telemedicine implementation of the CDC’s STEADI older adult fall prevention initiative implemented among adults ages 65 and older at increased risk for falls.
METHODS: Using STEADI Options and published data, we simulated the intervention’s cost-effectiveness as compared to standard of care from the healthcare payer’s perspective, over a one-year time horizon with a 0% discount rate. Using an incremental net benefit (INB) framework we estimated cost-effectiveness assuming a baseline willingness-to-pay (WTP) of $25 478 to prevent one medically treated fall and performed univariate and probabilistic sensitivity analyses.
RESULTS: Cumulatively when compared to the control participants, those in the intervention cost -$873 (95% U.I. -$3839, $2081) less, experienced fewer falls treated within the healthcare system -0.037 (95% Confidence interval (C.I.), -0.090, 0.015), and fewer falls treated by other providers -0.007 (95% C.I. -0.070, 0.053). The intervention’s INB of $1995 (95% U.I. -$2166, $6118) per enrollee, was cost saving in 71.8% of simulations and cost-effective in 82.9% of simulations. Cost-effectiveness was insensitive to wide changes in the model’s parameters, was cost-effective in 71.8% of simulations at a WTP of $0 and 85.4% of simulations at a WTP of $50 000.
CONCLUSION: Within the study cohort, the intervention was highly likely to be cost-effective. However, differences in medically treated falls and total healthcare costs were not statistically significant; therefore, we cannot rule out the possibility that the intervention had no impact.
PMID:42315165 | DOI:10.1093/ageing/afag141
