Cost-effectiveness of adopting a postoperative delirium risk prediction tool with nonpharmacological delirium prevention interventions for surgical patients.

This article evaluates the cost-effectiveness of adopting the Pre-Interventional Preventive Risk Assessment (PIPRA) tool for screening older surgical inpatients (aged 60 and above) at risk of postoperative delirium (POD) within the Swiss healthcare system. Using a decision tree model informed by a before–after study in a Swiss private hospital, the analysis found that implementing PIPRA combined with targeted nonpharmacological interventions modestly reduced POD incidence and improved health outcomes measured by quality adjusted life years (QALYs). The adoption of PIPRA was associated with an average cost saving of 2,898 CHF per patient and a small QALY gain of 0.01, with a 99.7% probability of cost savings and a 91% probability of cost-effectiveness at a willingness-to-pay threshold of 100,000 CHF per QALY. The study notes limitations including a relatively young and fit patient sample and the observational design, suggesting further evaluation in randomized trials and diverse settings is needed to confirm generalizability.