A primary-care falls programme that saved money

Design

Within-trial economic evaluation alongside a cluster randomised controlled trial

Population

2,610 community-dwelling older adults in rural China

Primary outcome

Cost-effectiveness (falls prevented and quality-adjusted life-years)

Effect

Dominant (cheaper and more effective); absolute falls reduction 8.6%; 96% probability cost-effective

Falls prevention works, but cost is often the barrier to scaling it, especially in lower-resource settings. This economic evaluation ran alongside the FAMILY cluster randomised trial of 2,610 community-dwelling older adults in rural China, which tested a balance and functional-exercise programme delivered through primary healthcare.

Over a mean of about a year, the programme was dominant: it both improved outcomes and cost less. It reduced the absolute risk of falls by 8.6% and gained 0.024 quality-adjusted life-years per person, while saving a mean of 293 yuan per participant, driven by lower healthcare use that outweighed the small 20-yuan delivery cost. The probability of being cost-saving was 90%, and of being cost-effective, 96%.

The message is that a simple, primary-care-integrated exercise programme can prevent falls and pay for itself in a resource-constrained setting. For countries with rapidly ageing populations and stretched budgets, including India, this is a model worth adapting rather than importing expensive specialist falls services.

• Economic evaluation alongside a cluster trial of 2,610 older adults in rural China.
• The primary-care balance and exercise programme reduced absolute falls risk by 8.6%.
• It was cost-saving (mean 293 yuan per participant) and gained 0.024 quality-adjusted life-years.
• Probability of being cost-saving was 90%, and cost-effective 96%.
• A scalable, low-cost model for resource-constrained, rapidly ageing settings.

Why it matters

It shows effective falls prevention need not be expensive or specialist-led, which is the usual obstacle to delivering it at scale.

Don't overread it

This is a within-trial economic evaluation from rural China; the exact savings are uncertain and the model needs local adaptation before the figures transfer to other systems.

The statistics, in plain English

Dominant means cheaper and more effective at once, the strongest health-economic result; the cost-saving interval crosses zero, so the money saved is uncertain, but the high probabilities of cost-effectiveness make the case robust within this trial.

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