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BACKGROUND With the aging world population, the incidence of falls has intensified and fall-related hospitalization costs are increasing. Falls are one type of event studied in the health economics of patient safety, and many developed countries have conducted such research on fall-related hospitalization costs. However, China, a developing country, still lacks large-scale studies in this area. AIM To investigate the factors related to the hospitalization costs of fall-related injuries in elderly inpatients and establish factor-based, cost-related groupings. METHODS A retrospective study was conducted. Patient information and cost data for elderly inpatients (age ≥ 60 years, n = 3362) who were hospitalized between 2016 and 2019 due to falls was collected from the medical record systems of two grade-A tertiary hospitals in China. Quantile regression (QR) analysis was used to identify the factors related to fall-related hospitalization costs. A decision tree model based on the chi-squared automatic interaction detector algorithm for hospitalization cost grouping was built by setting the factors in the regression results as separation nodes. RESULTS The total hospitalization cost of fall-related injuries in the included elderly patients was 180479203.03 RMB, and the reimbursement rate of medical benefit funds was 51.0% (92039709.52 RMB/180479203.03 RMB). The medical material costs were the highest component of the total hospitalization cost, followed (in order) by drug costs, test costs, treatment costs, integrated medical service costs and blood transfusion costs The QR results showed that patient age, gender, length of hospital stay, payment method, wound position, wound type, operation times and operation type significantly influenced the inpatient cost ( P < 0.05). The cost grouping model was established based on the QR results, and age, length of stay, operation type, wound position and wound type were the most important influencing factors in the model. Furthermore, the cost of each combination varied significantly. CONCLUSION Our grouping model of hospitalization costs clearly reflected the key factors affecting hospitalization costs and can be used to strengthen the reasonable control of these costs.

ObjectiveSocial participation has become a policy framework to address population aging. However, little is known about the social participation of older adults in western China, and extensive, multicenter, regional research is lacking. This research investigated the profiles of social participation of older adults in western China and explored the characteristics and factors influencing social participation.MethodThis cross-sectional study was conducted in 3 provinces (Chongqing, Sichuan, and Inner Mongolia) in western China from March 2021 to December 2021 and included 3,456 participants aged 60 years or older. Social participation was assessed using the Chinese version of the Impact on Participation and Autonomy Questionnaire (IPA). Latent profile analysis (LPA) was performed to extract latent classes of social participation among older adults in western China. The chi-square test and multinomial regression analyses were used to identify differences between these classes.ResultsThree social participation classes were identified by LPA: high social participation (25.2%), moderate social participation (55.1%), and low social participation (19.7%). Being older, having a primary school education level, having mobility or speaking impairment, using assistive devices, and having a chronic disease were highly associated with the low social participation class (P &lt; 0.05). Furthermore, older adults with no dependence (OR = 0.018, 95% CI = 0.005–0.062) or mild dependence (OR = 0.039, 95% CI = 0.011–0.139) in activities of daily living (ADLs) were less likely to be in the low social participation class. Older adults who were cared for by non-spouse primary caregivers were more likely to be assigned to the moderate social participation group (OR = 2.097, 95% CI = 1.501–2.930) than to the high social participation group.ConclusionsMost older adults in western China have a moderate level of social participation. Advanced age, reduced ADL ability, reduced speech ability, reduced mobility, and non-spouse care are related to the level of social participation. Healthcare professionals should pay attention to the predictors for different classes, identifying high-risk groups as early as possible.

Background: Frailty has been described as the most problematic expression in the context of considerable aging progression. Moreover, frailty-associated disability severely affects individuals and the society. Evidence has suggested that assistive devices (ADs) usage can slow functional decline, improve dependency and well-being with aging. Considering there is a paucity of published evidence on elderly assistive aids for the management of frailty, the present study aimed to shed light on the potential mediating effect of assistive devices usage on the frailty through the relationship between frailty and disability, and provide a theoretical basis for a health behavior intervention for frailty. Methods: Convenience sampling method was used to select 335 older adults aged over 60 years using the FRAIL scale and the Barthel index for Activities of Daily living (ADL). Pearson’s r correlations were used to examine the association between the frailty, disability and assistive devices use and structural equation modelling (SEM) was to test a hypothetical mediation model. Results: Of the 335 sample aged 60 or older, the participants’ mean age was 70.8 years old (SD = 6.6), mean scores of frailty and ADL disability was 2.71 (SD = 1.3) and 50.39 (SD = 24.5), respectively. Merely 21.8% of the participants were using ADs. Pearson’s ranalsysi demonstrated that ADL disability and ADs use were significantly correlated with frailty. Lastly, ADs use mediated the relationship between frailty and disability. Conclusions: This study demonstrates that ADs usage may potentially serve as a tool for frailty management by mediating the association between frailty and disability. However, at present, ADs usage rate is rather low at the context of amounting rates of frailty. Therefore, the routine assessment of frailty and prescription of elderly assistive products are crucial when designing and implementing health promotion programme for elderly persons.