Preventing falls among the community-dwelling elderly
Analyzing the impact of fall prevention programs and evaluating the applicability of a Health Impact Bond
J.J.A. van Berckel (TU Delft - Technology, Policy and Management)
J.L.T. Blank – Mentor (TU Delft - Economics of Technology and Innovation)
HG Van Der Voort – Graduation committee member (TU Delft - Organisation & Governance)
Umar Ikram – Coach
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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.