The Cost of Falls Among the Community-Dwelling Elderly

OBJECTIVES: To estimate the direct medical costs of falls in the population of community-dwelling elderly. METHODS: Data from a sample of 4,025 consumers from the 1997 Medical Expenditure Panel Survey were used to make estimates that were representative of the population of civilian, noninstitutionalized elderly in the United States. RESULTS: In 1997, 9% of the noninstitutionalized elderly population of the United States reported medical conditions related to falls. The estimated total direct medical cost of these conditions was $6.2 billion in 1997 dollars and $7.8 billion in 2002 dollars. The mean cost per person who had fallen was $2,039 in 1997 dollars and $2,591 in 2002 dollars. Inpatient hospitalizations accounted for 65% of total costs, followed by office-based medical visits and home health care, each accounting for about 10% of total direct medical costs, and hospital outpatient visits for 7.6%. About 78% of fall-related costs were reimbursed by Medicare. CONCLUSIONS: Fall-related medical conditions affect a substantial number of the community-dwelling elderly and result in direct medical costs of $6 to $8 billion per year in the United States. The total economic burden of falls is significantly higher because this estimate does not include direct nonmedical, intangible, and indirect costs. The results of this study highlight the importance of research aimed at decreasing the incidence and severity of falls in the elderly.

[1]  P. Shekelle,et al.  Interventions for the prevention of falls in older adults: systematic review and meta-analysis of randomised clinical trials , 2004, BMJ : British Medical Journal.

[2]  R. Cumming,et al.  Interventions for preventing falls in elderly people. , 2003, The Cochrane database of systematic reviews.

[3]  W. Hazzard,et al.  Principles of Geriatric Medicine and Gerontology , 2003 .

[4]  W. Leslie,et al.  Preventing falls in elderly persons. , 2003, The New England journal of medicine.

[5]  Joel W. Cohen,et al.  Spending and service use among people with the fifteen most costly medical conditions, 1997. , 2003, Health affairs.

[6]  R. Keller,et al.  Strategies for prevention of medication-related falls in the elderly. , 2003, The Consultant pharmacist : the journal of the American Society of Consultant Pharmacists.

[7]  M. Tinetti Clinical practice. Preventing falls in elderly persons. , 2003, The New England journal of medicine.

[8]  Harold Alan Pincus,et al.  The most expensive medical conditions in America. , 2002, Health affairs.

[9]  R. Cumming Intervention strategies and risk-factor modification for falls prevention. A review of recent intervention studies. , 2002, Clinics in geriatric medicine.

[10]  C. Gabrel,et al.  The National Nursing Home Survey: 1995 summary. , 2000, Vital and health statistics. Series 13, Data from the National Health Survey.

[11]  M. Tinetti,et al.  Drugs and Falls in Older People: A Systematic Review and Meta‐analysis: I. Psychotropic Drugs , 1999, Journal of the American Geriatrics Society.

[12]  Christianna S. Williams,et al.  Health care utilization and costs in a Medicare population by fall status. , 1998, Medical care.

[13]  Christianna S. Williams,et al.  Falls, injuries due to falls, and the risk of admission to a nursing home. , 1997, The New England journal of medicine.

[14]  T. M. Kashner,et al.  The Economic Cost of Hip Fractures in Community‐Dwelling Older Adults: A Prospective Study , 1997, Journal of the American Geriatrics Society.

[15]  F Englander,et al.  Economic dimensions of slip and fall injuries. , 1996, Journal of forensic sciences.

[16]  M. Tinetti,et al.  The cost-effectiveness of a multifactorial targeted prevention program for falls among community elderly persons. , 1996, Medical care.

[17]  M. Tinetti,et al.  Risk Factors for Serious Injury During Falls by Older Persons in the Community , 1995, Journal of the American Geriatrics Society.

[18]  T. Clancy,et al.  Hospital Resources Used To Treat the Injured Elderly at North Carolina Trauma Centers , 1993, Journal of the American Geriatrics Society.

[19]  M. Wolf,et al.  The cost and frequency of hospitalization for fall-related injuries in older adults. , 1992, American journal of public health.

[20]  J. F. Fitzgerald,et al.  Falling, Health Status, and the Use of Health Services by Older Adults: A Prospective Study , 1992, Medical care.

[21]  V. Mor,et al.  Health Care Utilization and Functional Status in the Aged Following a Fall , 1991, Medical care.

[22]  J G Rodriguez,et al.  The incidence of fall injury events among the elderly in a defined population. , 1990, American journal of epidemiology.

[23]  M. Tinetti,et al.  Risk factors for falls among elderly persons living in the community. , 1988, The New England journal of medicine.

[24]  B. Isaacs,et al.  Prognosis of falls in old people at home. , 1981, Journal of Epidemiology and Community Health.

[25]  J. Eisenberg Agency for Health Care Policy and Research. , 1999, Medical care.

[26]  F. Englander,et al.  Commentary on Englander F, Hodson TJ, Terregrossa RA. Economic dimensions of slip and fall injuries. J Forensic Sci 1996: 41(5):733-746 [1] (multiple letters) , 1997 .

[27]  A. M.P.H.DeborahA.AdamsTimothyM.CopelandPatsyA.HallCa,et al.  Incidence and costs to Medicare of fractures among Medicare beneficiaries aged > or = 65 years--United States, July 1991-June 1992. , 1996, MMWR. Morbidity and mortality weekly report.