Health system costs of falls of older adults in Western Australia

Abstract

The aim of this study was to determine the health system costs associated with falls in older adults who had attended an emergency department (ED) in Western Australia. The data relating to the ED presentations and hospital admissions were obtained from population-based hospital administrative records for [2001][2002]. The type of other health services (eg, outpatient, medical, community, ancillary and residential care), the quantity, and their cost were estimated from the literature.In adults aged 65 years and above, there were 18 706 ED presentations and 6222 hospital admissions for fall-related injuries. The estimated cost of falls to the health system was $86.4 million, with more than half of this attributable to hospital inpatient treatment. Assuming the current rate of falls remains constant for each age group and gender, the projected health system costs of falls in older adults will increase to $181 million in 2021 (expressed in 2001-02 Australian dollars).The economic burden to the health services imposed by falls in older adults is substantial, and a long-term strategic approach to falls prevention needs to be adopted. Policy in this area should be targeted at both reducing the current rate of falls through preventing injury in people from high-risk groups and reducing the future rate of falls

Falls in the acute hospital setting — impact on resource utilisation

“…There have been a number of studies highlighting the high costs associated with falls for older people living in the community, [27][28][29][30] however there are few data about costs associated with falls in hospitals, particularly in the Australian health care setting. A study in the United Kingdom estimated costs of treating orthopaedic fall-related injuries that occurred in hospital over a 3-year period to be about £127000 (covering surgery and bed-costs only), with most patients with these injuries requiring between 1 and 5 weeks' additional stay in hospital.…”

Hospital and non-hospital costs for fall-related injury in community-dwelling older people

“…This figure is lower than the average costs reported in Australian studies by Potter-Forbes and Aisbett ($5688), Hall and Hendrie ($4291) and Hendrie et al ($4619). 13,15,16 The lower cost is most likely due to a greater capture of people who had minor injuries that required treatment only from a medical practitioner or allied health worker: $1600 is therefore likely to represent a more accurate estimate of all injurious falls suffered by older people in community. When the analyses were restricted to participants attending the ED (and possible subsequent hospital admission), the average cost was $6756.…”

“…This figure is more comparable to the previous studies that used indirect means for estimating nonhospital care or recruited their study population from ED attendees only. 13,15,16 Only 4% of the falls that resulted in injuries led to admission to hospital. Despite this, hospital costs accounted for 67% of the total cost of injury-related health care.…”

“…Nevertheless, the findings are similar to recent Australian studies that have assessed costs in general community populations. 13,15,16 A further limitation is that indirect costs were not ascertained. Previous research has shown indirect costs to be quite substantial in relation to fall injury, so the figures from this study do not provide the total extent of the economic burden of falls injuries.…”

“…A larger, subsequent study by the same authors found that more than half of the total fall-related health-care cost was attributed to hospital inpatient care when costs were examined for people attending emergency departments (EDs) in Western Australia over a one-year period. 16 A limitation of these study designs, however, is that they only included subjects who had attended a hospital ED following a fall-related injury, thereby limiting the focus to the small percentage of falls that result in serious injury.…”