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Modelling the population-level impact of tai-chi on falls and fall-related injury among community-dwelling older people
  1. Lesley Day1,
  2. Caroline F Finch2,
  3. James E Harrison3,
  4. Effie Hoareau1,
  5. Leonie Segal4,
  6. Shahid Ullah2
  1. 1Monash University Accident Research Centre, Melbourne, Australia
  2. 2School of Human Movement and Sport Sciences, University of Ballarat, Ballarat, Australia
  3. 3Research Centre for Injury Studies, Flinders University, Adelaide, Australia
  4. 4University of South Australia, School of Nursing and Midwifery, Adelaide, Australia
  1. Correspondence to Dr Lesley Day, Monash University Accident Research Centre, Clayton, Melbourne, Victoria 3800, Australia; lesley.day{at}monash.edu

Abstract

Objective To model the population level impact of tai-chi on future rates of falls and fall-related injury in older people as a tool for policy development.

Design An epidemiological and economic model for estimating population-level effectiveness of tai-chi.

Setting Australia, 2009.

Patients or subjects Australian community-dwelling population aged 70+ years, ambulatory and without debilitating conditions or profound visual defects.

Intervention Group-based tai-chi, for 1 h twice weekly for 26 weeks, assuming no sustained effect beyond the intervention period.

Main outcome measure Total falls and fall-related hospitalisation prevented in 2009.

Results Population-wide tai-chi delivery would prevent an estimated 5440 falls and 109 fall-related hospitalisations, resulting in a 0.18% reduction in the fall-related hospital admission rate for community-dwelling older people. The gross costs per fall and per fall-related hospital admission prevented were $A4414 (€3013) and $A220 712 (€150 684), respectively. A total investment of $A24.01 million (€16.39 million), equivalent to 4.2% of the cost of fall-related episodes of hospital care in 2003/4, would be required to provide tai-chi for 31 998 people and achieve this effect.

Conclusions Substantial investment in, and high population uptake of, tai-chi would be required to have a large effect on falls and fall-related hospitalisation rates. Although not accounted for in this study, investment in tai-chi is likely to be associated with additional significant health benefits beyond falls prevention. This approach could be applied to other interventions to assist selection of the most cost-effective falls-prevention portfolio for Australia and other countries.

  • Accidental falls
  • tai-chi
  • aged
  • evidence-based practice
  • epidemiological modelling
  • elderly
  • falls
  • methods
  • policy

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Footnotes

  • Funding This project was funded through the Australian Government Department for Health and Ageing (Falls and Community Injury Grants Program). LD and CF were supported by National Health and Medical Research Council (NHMRC) Senior Research and Principal Research Fellowships, respectively. SU was supported by an Injury Trauma and Rehabilitation (ITR) Research Fellowship funded through a NHMRC Capacity Building Grant in Population Health.

  • Competing interests None.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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