Epidemiology of Falls
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FALLS ARE COMMON
- 27% or 1 in 4 older adults falls each year
- Every 20 minutes an older adult dies from a fall in the US
FALLS ARE COSTLY
- Falls cost the US healthcare system $50 billion each year
- 75% of total falls cost are paid by Medicare and Medicaid
Common
- 27% of community-dwelling persons >65 and 50% of persons >80 fall each year
- From 2005–2009, fall-related visits to the ED increased by almost 30%.
- Falls are also on the rise.
- Motor vehicle crash mortality rates have decreased in the last decade due to decreased severity of injuries and safer cars
- Conversely, between 2002 and 2010
- fall-related mortality increased by 46%
- the number of fall-related injuries increased by 23%
- In this age group, the mortality rate from falls now exceeds motor vehicle crashes and firearms injuries.
Cost
- In 2000, there were 2.6 million nonfatal fall injuries with a total annual cost of $19 billon. Incidence of falls varied little with age, yet the cost of care doubled between ages 65–74 and 75–84.
- For fatal falls, >10,000 occurred in 2000 with an estimated cost of $179 million. Both the incidence and cost increased with age and were nearly 20% more for women.
- Cost-related calculations not accounted for in this study included the 12% of older adults who fell that subsequently required long-term nursing home care.
- These calculations also do not account for costs associated with lost wages, informal caregivers, wheelchair ramps, reduced quality of life for the injured elder, or insurance claim processing costs.
WHY IS THE ED SO IMPORTANT IN THIS?
- Significant numbers of opportunities to intervene on modifiable risk factors are missed in the ED. One study showed that using current ED practice, we missed diagnosing 96% of modifiable risk factors in older ED patients presenting after a fall. Interestingly, in those that we did diagnose a risk factor, providers only occasionally intervened.
- Teachable moment
- Primary care providers might not know about the fall.
References
Burns ER et al. J Safety Res. 2016;58:99–103. Centers for Disease Control and Prevention. www.cdc.gov/steadi/. Accessed June 3, 2019. Allen SR et al. In: Luchette FA et al, eds. Geriatric Trauma and Critical Care. New York: Springer; 2017:247–253.
Kahn JH et al, eds. Geriatric Emergency Medicine: Principles and Practice. Cambridge University Press; 2014. Dalton T et al. JEMS. 2015. https://www.jems.com/articles/print/volume-40/issue-11/features/complexities-of-geriatric-trauma-patients.html. Accessed June 3, 2019. Sise RG et al. J Trauma Acute Care Surg. 2014;76(4):913–919.