106 | Chapter 6 (258). We valued absenteeism from paid work and presenteeism using the Dutch average gross hourly wages from 2022 (258). Participants reported their perceived efficiency while working with health complaints, referred to as the efficiency score. Lost productivity was calculated using the formula: (1 − efficiency score) × number of days with health complaints × hours worked per day. This value was then monetized based on gender-specific wage rates. All standard prices were adjusted for inflation to reflect the prices from 2022 using the consumer price index (CPI) from Statistics Netherlands (262). Discounting costs was unnecessary due to the trial’s 12-month follow-up period. The costs of the In Balance intervention were estimated according to a template of VeiligheidNL, and divided among the maximum number of 12 participants per training group, see Appendix 6.1, Table A6.1 for an overview of this calculation. Effects The primary outcome measures in this trial were the number of falls and the number of injuries due to a fall. A fall was defined as an unintentional descent to the ground or a lower level (55). We assessed the occurrence of falls and fall-related injuries during the 12-month follow-up period with fall diaries and monthly follow-up telephone calls. When a fall event was reported, detailed information regarding its consequences was systematically collected from the participants to obtain information on the fall-related injuries. The primary outcome measures in the economic evaluation were Quality-Adjusted Life Years (QALYs). This metric combines quality and quantity of life (263). Quality of life was measured using the EuroQol Five-level questionnaire (EQ-5D-5L) and the Adult Social Care Outcomes Toolkit (ASCOT). The EQ-5D-5L and ASCOT were both assessed at baseline, and at months 4, 8 and 12 of follow-up. We incorporated the ASCOT additionally to the EQ-5D-5L, due to its broader scope in assessing quality of life (264). The resulting EQ-5D-5L and ASCOT health states were converted into utility scores using the Dutch EQ-5D-5L and ASCOT tariffs (265, 266). Utility scores are anchored at 0 (death) and 1 (full health) and are multiplied with the time spent in a specific health state. Changes in health states between timepoints were linearly interpolated. The maximum number of QALYs to be experienced per person was 1 due to the total of 1 year follow-up in the study. Statistical analysis The analysis consisted of a cost-effectiveness analysis (CEA) and a cost-utility analysis (CUA) according to the intention-to-treat (ITT) principle. The analyses were carried out using RStudio (Version 2023.12.1+402).
RkJQdWJsaXNoZXIy MjY0ODMw