Cost--utility analysis of a shock-absorbing floor intervention to prevent injuries from falls in hospital wards for older people

Age Ageing. 2013 Sep;42(5):641-5. doi: 10.1093/ageing/aft076. Epub 2013 Jul 9.


Background: hospital falls place a substantial burden on healthcare systems. There has been limited research into the use of hospital flooring as an intervention against fall-related injuries.

Objective: to assess the cost-effectiveness of shock-absorbing flooring compared with standard hospital flooring in hospital wards for older people.

Design: a cost-utility analysis was undertaken drawing upon data collected in a pilot cluster randomised controlled trial and the wider literature.

Setting: the trial included eight hospital sites across England. Four sites installed shock-absorbing flooring in one bay, and four maintained their standard flooring.

Measurements: falls and resulting injuries and treatment were reported by hospital staff. Data on destination of discharge were collected. Patients were followed up at 3 months and further resource use data were collected. Health-related quality of life was assessed, allowing quality-adjusted life years (QALYs) to be estimated. The incremental cost-effectiveness ratio of the shock-absorbing flooring was assessed compared with the standard hospital flooring.

Results: in the base case, the shock-absorbing flooring was cost saving, but generated QALY losses due to an increase in the faller rate reported in the intervention arm. Scenario analysis showed that if the shock-absorbing flooring does not increase the faller rate it is likely to represent a dominant economic strategy-generating cost savings and QALY gains.

Conclusion: the shock-absorbing flooring intervention has the potential to be cost-effective but further research is required on whether the intervention flooring results in a higher faller rate than standard flooring.

Trial registration: NCT00817869.

Keywords: cost-effectiveness; falls; flooring-intervention; older people.

Publication types

  • Multicenter Study
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Accidental Falls / economics*
  • Age Factors
  • Aged
  • Aged, 80 and over
  • Cost Savings
  • Cost-Benefit Analysis
  • England
  • Female
  • Floors and Floorcoverings / economics*
  • Hospital Costs*
  • Hospital Units / economics*
  • Humans
  • Inpatients*
  • Male
  • Models, Economic
  • Pilot Projects
  • Quality-Adjusted Life Years
  • Time Factors
  • Wounds and Injuries / diagnosis
  • Wounds and Injuries / economics*
  • Wounds and Injuries / etiology
  • Wounds and Injuries / prevention & control*

Associated data