Predicting Falls in People Aged 65 Years and Older from Insurance Claims

Abstract

BACKGROUND Accidental falls among people aged 65 years and older caused approximately 2,700,000 injuries, 27,000 deaths, and cost more than 34 billion dollars in the United States annually in recent years. Here, we derive and validate a predictive model for falls based on a retrospective cohort of those 65 years and older. METHODS Insurance claims from a one year observational period were used to predict a fall-related claim in the following two years. The predictive model takes into account a person’s age, sex, prescriptions, and diagnoses. Through random assignment, half of the people had their claims used to derive the model, while the remaining people had their claims used to validate the model. RESULTS Out of 120,881 individuals, with Aetna health insurance coverage, 12,431 (10.3%) members fell. During validation, people were risk stratified across 20 levels, where those in the highest risk stratum had 10.5 times the risk as those in the lowest stratum (33.1% vs. 3.1%). CONCLUSIONS Using only insurance claims, individuals in this large cohort at high risk of falls could be readily identified up to two years in advance. Although external validation is needed, the findings support the use of the model to better target interventions.

The study of features and prospects of the insurance medicine in Ukraine in modern conditions

“…При добровільному страхуванні страхові установи ухиляються від страхування об'єктів, для яких ха-рактерна висока небезпека настання страхових подій, а також через значні накладні витрати, неминуче пов'язані зі страхуванням ризиків, за які може бути внесена незначна страхова сума. Якщо носії цих ризиків могли б усвідомити значення страхування, то вони не змогли б їм скористатися тому, що не знайшлося б страхової установи, готової страхувати такі ризики [9].…”

Risk Factors Associated with Falls among Nursing Home Residents: A Case-Control Study

“…Paresthesia, due to peripheral neuropathy or sensorial loss, produces several sudden sensations, which in turn can decrease motor and spatial perceptions, which ultimately results in falls [20,21]. The overactive bladder is a strong predictor of falls in older adults, which is associated with the urgency of having to get to the restroom [4,[22][23][24]. Insomnia as well as the medication prescribed for sleep disorders are also associated with a risk of falls [24,25].…”

“…The overactive bladder is a strong predictor of falls in older adults, which is associated with the urgency of having to get to the restroom [4,[22][23][24]. Insomnia as well as the medication prescribed for sleep disorders are also associated with a risk of falls [24,25]. Poor sleep quality can cause a decrease in physical ability among older adults [25].…”

“…Due to the high rate of morbidity, as well as chronic degenerative diseases and disabilities, older adults resort to health services more often when compared to mature adults, especially to emergency services [27, 28]. Also due to multiple diseases, older adults tend to take a lot of medicines, with polypharmacy being one of the severe problems related to falls [4, 8, 23, 24, 29, 30].…”

Factors included in adult fall risk assessment tools (FRATs): a systematic review

“…Internationally, it is estimated that a third of community-dwelling older people may experience accidental falls every year and among these fallers, 35.5 per cent may experience recurrent falls (Hung et al, 2017). According to the Centers for Disease Control and Prevention, more than 2.7 million older adults are injured annually from falls in the United States of America (Homer et al, 2017).…”