Cost-effectiveness of fall prevention programs based on home visits for seniors aged over 65 years: a systematic review

Background: Preventive home visits (PHVs) are considered a promising intervention to improve health and independent functioning of the elderly whilst reducing health care costs. This systematic review focuses on cost-effectiveness of PHVs, analyzing randomized controlled trials evaluating incremental cost-effectiveness ratios in fall prevention interventions. Methods: Based on an online search (PubMed) and bibliographic findings in the eligible articles, five studies providing relevant information were reviewed. Results: While three studies indicate cost-effectiveness, one delivered no statistically significant results, and one proved cost-effectiveness only for a subgroup of the study sample. Conclusions: Cost-effectiveness of PHVs appears to depend on careful adaptation of particular measures, for certain settings in special environments for designated patients and disease patterns, on a case-by-case basis. Starting points for further research are the components of the economic evaluation, the setting, personnel and measures of the intervention, as well as the careful selection and analysis of the study sample and its subgroups. A uniform follow-up time, standardized cost measurement as well as the use of standardized denominators like quality adjusted life years (based on the EQ-5D questionnaire) could build a foundation for comparable results.