Preventing falls among the community-dwelling elderly

Analyzing the impact of fall prevention programs and evaluating the applicability of a Health Impact Bond

Master thesis (2019)

Authors

J.J.A. van Berckel Technology, Policy and Management

Contributors

J.L.T. Blank Economics of Technology and Innovation - TPM (supervisor 1)
H.G. van der Voort Organisation & Governance - TPM (supervisor 2)
Umar Ikram (coach)
Faculty
Technology, Policy and Management
Copyright: © 2019 Joost van Berckel
Python evaluation tool Hospital data Fall prevention programs Dordrecht, Netherlands Difference-in-Differences
More Info
expand_more

Published Date

06-07-2019

Language

English

Reuse Rights

Other than for strictly personal use, it is not permitted to download, forward or distribute the text or part of it, without the consent of the author(s) and/or copyright holder(s), unless the work is under an open content license such as Creative Commons.

Faculty

Technology, Policy and Management

Abstract

Fall prevention programs hold great promise to improve quality of life among older adults and to decrease healthcare expenditures. However, there are substantial barriers for entrepreneurs working in the elderly care to set up fall prevention programs, due to the size of the investments required, the uncertainty of the parties about the potential benefits from the reduction in healthcare expenditures and the divergence of interests within our fragmented healthcare system. Hence, a method to assess the effect of fall prevention programs is needed, and, if these programs indeed appear to have a positive effect on the healthcare costs, there might be possibilities to use an innovative financing structure, such as a Health Impact Bond (HIB), to encourage the implementation. A HIB is a performance-based instrument by which the financial risk shifts from local implementers to investors. During this research, a python tool was developed to determine the effect of fall prevention programs using hospital data. By doing a case study in Dordrecht, the economic feasibility of a HIB for fall prevention programs was assessed. A Difference-in-Differences design was used to determine the effect of the fall prevention programs on both the number of injurious fall incidents and healthcare costs. Other barriers for setting up these programs using a HIB regarding governance and law were identified.