Sammendrag:The aim of this study was to estimate the cost-effectiveness of implementing an exercisebased fall prevention programme for home-dwelling women in the 80-year age group in Norway. Methods: the impact of the home-based individual exercise programme on the number of falls is based on a New Zealand study. On the basis of the cost estimates and the estimated reduction in the number of falls obtained with the chosen programme, we calculated the incremental costs and the incremental effect of the exercise programme as compared with no prevention. The calculation of the average healthcare cost of falling was based on assumptions regarding the distribution of fall injuries reported in the literature, four constructed representative case histories, assumptions regarding healthcare provision associated with the treatment of the specified cases, and estimated unit costs from Norwegian cost data. We calculated the average healthcare costs per fall for the first year. Results: we found that the reduction in healthcare costs per individual for treating fallrelated injuries was 1.85 times higher than the cost of implementing a fall prevention programme. Conclusions: the reduction in healthcare costs more than offset the cost of the prevention programme for women aged 80 years living at home, which indicates that health authorities should increase their focus on prevention. The main intention of this article is to stipulate costs connected to falls among the elderly in a transparent way and visualize the whole cost picture. Cost-effectiveness analysis is a health policy tool that makes politicians and other makers of health policy conscious of this complexity.Omsorgsbiblioteket har ikke tilgang til å publisere dette dokumentet i fulltekst. Kanskje ditt lokale bibliotek kan hjelpe deg, eller kanskje du kommer videre med lenken nedenfor.

Aims: The aim of this study was to estimate the one-year health and care costs connected to a hip fracture for home dwelling patients 70 years and older in Norway, paying specific attention to patient status at the time of the fracture and cost differences due to various patient pathways after the fracture.Methods: Data on health and care service provision were extracted from hospital and municipal records and from national registries, while data on unit costs were collected from the municipality, the hospital administrations, and published studies. Four different patient pathways were identified and total costs for sub-groups of patients according to age, gender, fracture type, and instrumental activity of daily living at fracture incidence were calculated. Descriptive statistics were used to identify cost estimates.Results: The mean total one-year costs per patient were 68,376 EUR, and the costs for patients alive one year after the hip fracture constituted 71,719 EUR. The patients' age and pre-fracture functional status contributed most to the total costs.Conclusion: On average, care costs amounted for more than 50% of the total costs, and even for patients with good functional status before the hip fracture, care costs amounted to 40% as compared to hospital costs of 38%. To reduce the financial costs of hip-fractures for the care sector, the results point to the importance of preventive programs to reduce the risk of a hip fracture, but also to the importance of comprehensive geriatric care in the initial phase after a hip fracture.

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