Economic analysis of Tai Chi as a means of preventing falls and falls related injuries among older adults, CHERE Working Paper 2006/4

This study has examined the costs and consequences of a randomised controlled trial of a community based Tai Chi program for people over 60 years of age. The hypothesis for the trial was that compared to non-participants, participants in the Tai Chi program would have fewer falls and may experience additional health and other benefits. In terms of resource use it was anticipated that the Tai Chi program would use additional resources in terms of running costs but was expected to save resources as a result of falls prevented. Data for this economic evaluation were collected prospectively alongside the randomised controlled trial. The aim of this evaluation was to investigate the cost-effectiveness of Tai Chi as means of preventing falls in elderly people living in the community. Costs included were those of the Tai Chi trial and health service utilisation (including GP and specialist and other consultations, tests, hospitalisations and medications). Effectiveness was measured as the number of participants in the intervention and control groups, all participants and the number of falls avoided. SPSS was used to analyse the data; Fisher?s exact and the student?s t-test were used to test differences between the intervention and control groups. From the perspective of NSW Health, the cost of providing Tai Chi as part of this trial ($81232) outweighed any costs of health service provision ($24795). Only a small proportion used health services and this mostly involved the use of over-the-counter pain relieving medication and GP consultations. Only 3 people were admitted to hospital. There were no significant differences between the study and control groups in terms of utilisation and costs except in terms of overall costs where the control group costs were significantly more than the study group (p=0.43). However, this difference was driven by the cost of one admission to hospital. In the trial 3/216 falls resulted in hospitalisation. This means that for every 100 falls avoided, 1.4 serious falls were prevented. Assuming that Tai Chi would continue to prevent falls at the same rate as the trial, 740 individuals would need to participate in Tai Chi to avoid 100 falls and 1.4 serious falls. The value of avoiding a small number of serious falls must be weighed against the high cost of treating and managing the consequences of such falls.