Health economic evaluation of a medication safety intervention in elderly care: identifying causal effects in a multi-center quasi-experimental study design

The high prevalence of multimorbidity in the aging population necessitates complex medication regimens, increasing the risk of adverse drug events (ADEs) and hospital admissions. This paper evaluates an intervention aimed at improving medication safety for northeastern and western Germany under real...

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Bibliographic Details
Published in:BMC health services research Vol. 25; no. 1; pp. 773 - 15
Main Authors: Langenberger, Benedikt, Siegel, Martin, Busse, Reinhard, Vogt, Verena
Format: Journal Article
Language:English
Published: London BioMed Central 30.05.2025
BioMed Central Ltd
Springer Nature B.V
BMC
Subjects:
Adverse and side effects
Aged
Aged patients
Aged, 80 and over
Ambulatory care
Comorbidity
Cost-Benefit Analysis
Drug therapy
Drug-Related Side Effects and Adverse Reactions - economics
Drug-Related Side Effects and Adverse Reactions - prevention & control
Drugs
Economic aspects
Evaluation
Female
Geriatrics
Germany
Health Administration
Health Informatics
Hospital care
Hospitalization - economics
Hospitalization - statistics & numerical data
Hospitals
Humans
Interdisciplinary aspects
Intervention
Male
Medical care, Cost of
Medicine
Medicine & Public Health
Multimorbidity
Nursing care
Nursing homes
Nursing Research
Older people
Participation
Patient admissions
Polypharmacy
Propensity Score
Public Health
Reimbursement
Statistics
Germany
ISSN:1472-6963, 1472-6963
Online Access:Get full text
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Summary:The high prevalence of multimorbidity in the aging population necessitates complex medication regimens, increasing the risk of adverse drug events (ADEs) and hospital admissions. This paper evaluates an intervention aimed at improving medication safety for northeastern and western Germany under real-world conditions, thereby providing a pragmatic approach to the challenges of multi-center studies with staggered intervention starts and voluntary participation. The analysis utilizes iterative Propensity Score Matching (PSM) followed by a Difference-in-Differences (DiD) estimator to navigate the methodological complexities and assess the intervention’s effectiveness and cost-effectiveness. Results reveal a significant reduction in ADE-related hospital admissions by 27.5% and overall hospital admissions by 17.5%. We find that the intervention is cost-effective at an incremental cost-effectiveness ratio (ICER) of €15,169.66 per averted ADE and €4,180.61 per averted hospital admission. This study illustrates for evaluating complex health interventions in real-world settings and underscores the importance of balancing health outcomes improvements with economic considerations in aging populations.
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ISSN:1472-6963
1472-6963
DOI:10.1186/s12913-025-12898-0