6 The cost-effectiveness of the Dutch In Balance fall prevention intervention | 117 Subgroup analysis Table 6.4 presents the results for non-frail and pre-frail participants separately. Overall, results were similar to the main analysis with lower costs and better effects in the intervention group compared to control, although differences were not statistically significant. However, the cost difference in the pre-frail group (€-3,934) was slightly larger than in the non-frail group (€-3,774), whereas effect differences were slightly smaller in the pre-frail group than in the non-frail group. Overall, the conclusions regarding the cost-effectiveness of the intervention compared to control did not change. Table 6.4. Cost and effect differences, ICERs and distributions on the cost-effectiveness plane for the subgroup analysis stratified for frailty status. Outcome ΔC (95%CI) ΔE (95%CI) ICER Distribution CE-plane € Unit of effect €/unit of effect NE SE SW NW Subgroup analysis: Non-frail – In Balance (N= 40), Control (N= 37) Prevented fallsa -3,774 (-10,072; 2,523) 0.36 (-0.50; 1.23) -10,360 Dominant 2% 78% 19% 1% Prevented fall-related injuries*b -3,774 (-10,052; 2,504) 0.57 (0.07; 1.10) -6,667 Dominant 3% 96% 1% 0% QALY (EQ-5D-5L)c -3,774 (-10,077; 2,529) 0.04 (-0.01; 0.09) - 88,150 Dominant 3% 95% 2% 0% QALY (ASCOT)d -3,774 (-10,072; 2,524) 0.02 (-0.01; 0.06) -158,802 Dominant 3% 89% 8% 0% Subgroup analysis: Pre-frail – In Balance (N= 91), Control (N= 96) Prevented fallsa -3,934 (-9,879; 2,009) 0.25 (-0.89; 1.39) -15,559 Dominant 3% 61% 33% 3% Prevented fall-related injuriesb -3,934 (-9,852; 1,982) 0.15 (-0.35; 0.65) -26,306 Dominant 4% 69% 25% 2% QALY (EQ-5D-5L)c -3,934 (-9,844; 1,974) 0.02 (-0.05; 0.08) -223,746 Dominant 4% 69% 25% 2% QALY (ASCOT)d -3,934 (-9,864; 1,994) 0.03 (-0.01; 0.07) -122,036 Dominant 6% 90% 4% 0% Notes. C = costs, E = effects, ICER = Incremental Cost Effectiveness Ratio, CE-plane = Cost-effectiveness plane, 95%CI = 95% Confidence interval, SA = sensitivity analysis, NE = Northeast, SE = Southeast, SW = Southwest, NW = Northwest, Dominant = more effective and less costly. a Adjusted for age, sex, physical activity and emotional wellbeing. b Adjusted for age, sex and physical activity. c Adjusted for age, sex, baseline utility and emotional wellbeing. d Adjusted for age and sex, baseline utility and emotional wellbeing. *Significantly different between groups.
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