Tai Chi for the Prevention of Fractures in a Nursing Home Population: An Economic Analysis

• Objective: To ascertain the relative costs versus benefits of implementing a tai chi program in a typical nursing home. • Design: Literature-based cost-benefit analysis. • Data sources: Direct benefits were calculated from literature-based estimates and were restricted to hip fracture costs averted. Indirect benefits were calculated using the concept of willingness to pay to prevent morbidity or mortality. • Target population: Nursing home residents at average risk for fall. • Time horizon: 1 year. • Intervention modeled: Twice weekly Yang-style tai chi classes. • Results: Tai chi was cost-saving whether direct benefits alone (hip fracture costs averted) or direct plus indirect benefits were considered, with a total net cost savings of $1274.43 per person per year. When considering direct costs only, the net cost savings was $8.04 per participant per year. The model suggested that a tai chi intervention could avert 49.875 falls per 100 participants annually, at a cost of $172.68 per fall averted. Approximately 200 patient-years of tai chi exposure were required to prevent 1 hip fracture, at a cost of $17,268.17 per hip fracture averted, whereas 800 patient-years of tai chi exposure were needed to prevent 1 death, at a cost of between $64,294 and $66,694. Consideration of additional fall-related expenses would significantly broaden the economic feasibility of a tai chi intervention. • Conclusion: Tai chi is an economically feasible intervention to prevent hip fracture in nursing home residents. Despite the economically favorable analysis, policy makers are advised to await confirmatory studies of tai chi’s effectiveness and utility within this population before instituting such a program.