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Costs of Falls Among Older Adults

In 2012, the direct medical costs of older adult falls, adjusted for inflation, were $30 billion.1 With the population aging, both the number of falls and the costs to treat fall injuries are likely to increase.

How big is the problem?

  • One in three adults aged 65 and older falls each year.2 Of those who fall, 20% to 30% suffer moderate to severe injuries that make it hard for them to get around or live independently, and increase their risk of early death.3
  • Older adults are hospitalized for fall-related injuries five times more often than they are for injuries from other causes.4
  • In 2012, emergency departments treated 2.4 million nonfatal fall injuries among older adults; more than 722,000 of these patients had to be hospitalized.5

How are costs calculated?

The costs of fall-related injuries are often shown in terms of direct costs.

  • Direct costs are what patients and insurance companies pay for treating fall-related injuries. These costs include fees for hospital and nursing home care, doctors and other professional services, rehabilitation, community-based services, use of medical equipment, prescription drugs, changes made to the home, and insurance processing.
  • Direct costs do not account for the long-term effects of these injuries such as disability, dependence on others, lost time from work and household duties, and reduced quality of life.

How costly are fall-related injuries among older adults?

Photo: older adult man with doctor
  • In 2012, the total direct medical costs of fall injuries for people 65 and older, adjusted for inflation, was $30 billion.1
  • By 2020, the annual direct and indirect cost of fall injuries is expected to reach $67.7 billion (in 2012 dollars).6
  • Among community-dwelling older adults, fall-related injury is one of the 20 most expensive medical conditions.7
  • In 2002, about 22% of community-dwelling seniors reported having fallen in the previous year. Medicare costs per fall averaged between $13,797 and $20,450 (in 2012 dollars).8
  • Among community-dwelling seniors treated for fall injuries, 65% of direct medical costs were for inpatient hospitalizations; 10% each for medical office visits and home health care, 8% for hospital outpatient visits, 7% for emergency room visits, and 1% each for prescription drugs and dental visits. About 78% of these costs were reimbursed by Medicare.9
  • In a 1998 study of people age 72 and older, the average health care cost of a fall injury totaled $19,440, which included hospital, nursing home, emergency room, and home health care, but not doctors’ services.10

How do these costs break down?

Age and sex

  • The costs of fall injuries increase rapidly with age.1
  • Costs of both fatal and nonfatal falls are higher for women than for men.1
  • In 2000, medical costs for women, who comprised 58% of older adults, were two to three times higher than the costs for men.1

Type of injury and treatment setting

  • In 2000, 78% of fall deaths, and 79% of total costs, were due to traumatic brain injuries (TBI) and injuries to the lower extremities.1
  • Injuries to internal organs were responsible for 28% of fall deaths and accounted for 29% of costs.6
  • Fractures were both the most common and most costly nonfatal injuries. Just over one-third of nonfatal injuries were fractures, but these accounted for 61% of total nonfatal costs—or $18.8 billion (in 2012 dollars).1
  • Hospitalizations accounted for nearly two-thirds of the costs of nonfatal fall injuries and emergency department treatment accounted for 20%.1
  • On average, the hospitalization cost for a fall injury is $34,294 (in 2012 dollars).11
  • Hip fractures are the most serious and costly fall-related fracture. Hospitalization costs account for 44% of the  direct medical costs for hip fractures.12

References

  1. Stevens JA, Corso PS, Finkelstein EA, Miller TR. The costs of fatal and nonfatal falls among older adults. Injury Prevention 2006a;12:290–5.
  2. Tromp AM, Pluijm SMF, Smit JH, et al. Fall-risk screening test: a prospective study on predictors for falls in community-dwelling elderly. J Clin Epidemiol 2001;54(8):837–844.
  3. Sterling DA, O'Connor JA, Bonadies J. Geriatric falls: injury severity is high and disproportionate to mechanism. Journal of Trauma–Injury, Infection and Critical Care 2001;50(1):116–9.
  4. Alexander BH, Rivara FP, Wolf ME. The cost and frequency of hospitalization for fall-related injuries in older adults. American Journal of Public Health 1992;82(7):1020–3.
  5. Centers for Disease Control and Prevention, National Center for Injury Prevention and Control. Web–based Injury Statistics Query and Reporting System (WISQARS) [online]. Accessed November 30, 2010.
  6. Englander F, Hodson TJ, Terregrossa RA. Economic dimensions of slip and fall injuries. Journal of Forensic Science 1996;41(5):733–46.trial. The Gerontologist 1994;34(1):16–23.
  7. Stevens JA, Corso PS, Finkelstein EA, Miller TR. The costs of fatal and nonfatal falls among older adults. Injury Prevention 2006;12:290–5.
  8. Shumway-Cook A, Ciol MA, Hoffman J, Dudgeon BJ, Yorston K, Chan L. Falls in the Medicare population: incidence, associated factors, and impact on health care. Physical Therapy 2009.89(4):1-9.
  9. Carroll NV, Slattum PW, Cox FM. The cost of falls among the community-dwelling elderly. Journal of Managed Care Pharmacy. 2005;11(4):307-16.
  10. Rizzo JA, Friedkin R, Williams CS, Nabors J, Acampora D, Tinetti ME. Health care utilization and costs in a Medicare population by fall status. Medical Care 1998;36(8):1174–88.
  11. Roudsari BS, Ebel BE, Corso PS, Molinari, NM, Koepsell TD. The acute medical care costs of fall-related injuries among the U.S. older adults. Injury, Int J Care Injured 2005;36:1316-22.
  12. Barrett-Connor E. The economic and human costs of osteoporotic fracture. American Journal of Medicine 1995;98(suppl 2A):2A–3S to 2A–8S.

 

 
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