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Programme planning · Singapore dollars
What could falls preparedness save?
Explore potential avoided fall-related costs, net savings and return on investment for SMART MOVE or another community falls preparedness programme.
1. Population and effect
2. Cost of a fall
Assign each fall to its highest severity category. Shares must total 100%. Costs are complete, non-overlapping episode costs for the selected perspective. Hip-fracture falls are excluded from other admissions.
| Fall category | Share (%) | SGD / episode |
|---|---|---|
| No medical attendance | ||
| Outpatient / ED only | ||
| Other hospital admission | ||
| Hip-fracture admission |
All initial shares and costs are hypothetical. Do not substitute hip-fracture cost for average cost per fall.
Cost year: user-defined. Align all costs to the same price year.
3. Incremental programme cost
Potential impact
What needs to happen to break even?
Sensitivity to the assumed effect
Deterministic scenarios, not confidence intervals. Category shares and cost per fall remain unchanged.
| Fall-rate reduction | Net savings | ROI |
|---|
The same proportional reduction is assumed across severity categories. Evidence that exercise reduces all falls does not establish the same reduction in hip fractures or admissions. Fractional events are expected values, not observed counts.
Find defensible local figures
- Baseline fall rate: obtain prospectively recorded falls and person-time from the intended AAC population or a comparable untreated cohort. Divide total falls by person-years. Record missing follow-up and recurrent falls.
- Fall severity: link diaries and follow-up calls to ED, admission and fracture records. Divide falls in each mutually exclusive category by all recorded falls.
- Episode costs: request anonymised, aggregated resource use and cost data from hospital finance / health economics colleagues. Include ambulance, ED, acute admission and rehabilitation once only. Use means for expected aggregate costs; describe the skew and uncertainty.
- Public bill benchmarks: consult MOH bill information, matching diagnosis/procedure, hospital, ward and subsidy status. Bills and patient payments are not automatically healthcare resource costs.
- Programme micro-costing: use session logs, staff hours × loaded hourly rates, licence invoices, devices, training and maintenance. Subtract corresponding usual-care expenditure.
- Price-year alignment: use SingStat price indices. Adjust historical costs as original cost × target-year index / original-year index using a consistent series. A consumer health index remains a proxy for provider cost changes.
- SMART MOVE effect: use a suitable controlled evaluation of fall rate when available. Improvements in MdFES, balance or usability do not establish fewer falls or financial savings. A single-group pilot can inform feasibility and costing, but cannot establish causal effectiveness.
Evidence and model notes
Tan LTJ, Wong SJ, Kwek EBK. Singapore Med J. 2017;58:139–144. Retrospective TTSH cohort of 244 patients admitted in 2011; mean hospitalisation cost SGD 13,313.81. Historical inpatient episode only, not all fall costs or a current national estimate.
Sherrington et al. Cochrane Database Syst Rev. 2019;CD012424. Exercise fall-rate ratio 0.77 (95% CI 0.71–0.83), equivalent to a 23% reduction in rate. General community exercise evidence; not SMART MOVE evidence or proof of reduced costly injuries.
Equations and scope
Expected baseline falls = participants × baseline falls/person-year × months/12.
Weighted cost/fall = Σ(category share × category episode cost).
Avoided falls = baseline falls × relative rate reduction × transfer factor.
Avoided costs = avoided falls × weighted cost/fall. Programme cost = participants × delivery cost + fixed cost + research/development cost.
Net savings = avoided costs − programme cost. Net ROI = net savings / programme cost × 100%. Benefit–cost ratio = avoided costs / programme cost.
Break-even effective reduction = programme cost / baseline fall costs. Maximum break-even delivery cost/person = (avoided costs − fixed cost − research/development cost) / participants.
No discounting in this ≤12-month model. No QALYs, monetised confidence changes or assumed savings from shorter long lies. Add downstream care only within episode costs and without overlap. Societal scenarios require caregiver and participant costs on both sides. Healthcare savings and provider costs may accrue to different organisations.
Evidence checked 11 October 2026. No identifiable patient information is required or transmitted. Inputs remain in this page until reset or reloaded; exported files contain your scenario.