Abstract

Objective To determine the long-term cost-effectiveness of hip protector use in the prevention of hip fractures in elderly institutionalized residents in Germany compared to no prevention.

Methods A lifetime Markov decision model was developed using published data on costs and health outcomes. A societal and statutory health insurance perspective was adopted.

Results From a societal/statutory health insurance perspective, use of hip protectors yields savings of 315 EURO/257 EURO and a gain of 0.13 quality-adjusted life years per person over lifetime.

Conclusion Hip protector use in elderly institutionalised residents in Germany is highly cost-effective.

https://www.ncbi.nlm.nih.gov/pubmed/19602215
https://www.ncbi.nlm.nih.gov/pubmed/24834633
https://link.springer.com/article/10.1007/s00198-014-3008-7

Abstract

Background Public sector austerity measures in many high-income countries mean that public health budgets are reducing year on year. To help inform the potential impact of these proposed disinvestments in public health, we set out to determine the return on investment (ROI) from a range of existing public health interventions.

Methods We conducted systematic searches on all relevant databases (including MEDLINE; EMBASE; CINAHL; AMED; PubMed, Cochrane and Scopus) to identify studies that calculated a ROI or cost-benefit ratio (CBR) for public health interventions in high-income countries.

Results We identified 2957 titles, and included 52 studies. The median ROI for public health interventions was 14.3 to 1, and median CBR was 8.3. The median ROI for all 29 local public health interventions was 4.1 to 1, and median CBR was 10.3. Even larger benefits were reported in 28 studies analysing nationwide public health interventions; the median ROI was 27.2, and median CBR was 17.5.

Conclusions This systematic review suggests that local and national public health interventions are highly cost-saving. Cuts to public health budgets in high income countries therefore represent a false economy, and are likely to generate billions of pounds of additional costs to health services and the wider economy.

Health promotion interventions
Interventions aimed at reducing rates of falls are able to show one of the swiftest returns on investment of any of the public health interventions identified within this study, with a CBR of 20.6 returned within 18 months. Falls prevention interventions by their nature are relatively low cost, and yet their potential impact on demand management for hospital services is clearly demonstrated. Shifting investment from secondary care for the treatment of falls to primary prevention would show significant and swift returns on investment.

..... Furthermore, some are very rapid: falls prevention interventions reported substantial returns within 6–12 months. Beard J, Rowell D, Scott D, et al. Economic analysis of a community-based falls prevention program. J R Inst Public Health 2006;120:742–51.

http://jech.bmj.com/content/early/2017/03/07/jech-2016-208141