Twelve-month cost analysis of a geriatrician-led falls prevention clinic in Canada

INTRODUCTION: A geriatrician-led falls prevention clinic service (that includes the option of a physiotherapist) to prescribe and deliver exercise is an evidence-based model of care. The economic data are unknown. Therefore, for a 12-month period, we examined: 1) clinic demand, 2) clinic costs and 3) health resource use. METHODS: Clinic demand was quantified from a Falls Prevention Clinic Registry cohort for new and repeat visits and waitlist frequencies over 12 months. Costs of the Vancouver-based falls prevention clinic included operating and medical services plan costs. The number of falls experienced was self-reported. Health resource utilization from a healthcare system perspective was ascertained. Cost savings from falls averted over 12 months were estimated from literature and our randomized clinical trial data subset (n = 344) of falls prevention clinic users. We calculated the return on investment and benefit-cost ratio to reflect the incremental benefit of a structured home-based exercise program within the falls prevention clinic pathway. RESULTS: In 2024, annual demand for the falls prevention clinic totalled 543 visits (240 (44.2%) new baseline visits, 303 (55.8%) follow-up visits) with an average monthly waitlist of 30 individuals. Annual operating costs were ∼$317 thousand. Clinic demand costs were ∼$88 thousand (∼$51 thousand for new and ∼$37 thousand for follow-up visits). The cost of falls averted ranged from $1.5 million to $8.5 million based on a range of costs per fall of $4.2 thousand to $20 thousand. The return on investment ranged from ∼500% to 2.7 thousand %, while the benefit-cost ratio ranged from 6:1 to 28:1. DISCUSSION: The high return on investment yielded from the falls prevention clinic plus physiotherapist-delivered home-based exercise provides an economically attractive model of evidence-based care for falls prevention. TRIAL REGISTRATION: NCT01029171; NCT00323596 for the subsample.