A longitudinal analysis of total 3-year healthcare costs for older adults who experience a fall requiring medical care

J Am Geriatr Soc. 2010 May;58(5):853-60. doi: 10.1111/j.1532-5415.2010.02816.x. Epub 2010 Apr 6.

Abstract

Objectives: To compare longitudinal changes in healthcare costs between fallers admitted to the hospital at the time of the fall (admitted), those not admitted to the hospital (nonadmitted), and nonfaller controls; test hypotheses related to differences in mean costs between and within these groups over time; and estimate the costs attributable to falling.

Design: Longitudinal cohort.

Setting: Group Health Cooperative of Puget Sound.

Participants: Seven thousand nine hundred ninety-three nonadmitted fallers, 976 admitted fallers, and 8,956 nonfallers aged 67 and older enrolled in an integrated healthcare delivery system. Fallers were identified according to fall-related E-Codes and International Classification of Diseases, Ninth Revision codes recorded between January 1, 2004, and December 31, 2006. Nonfallers were frequency matched on age group and sex.

Measurements: Quarterly costs during a 3-year period were modeled using generalized estimating equations. Covariates included index age, sex, RxRisk (a comorbidity adjuster), fall status, time, and interactions between fall status and time.

Results: Cost differences between the faller cohorts and nonfallers were greatest in quarters closest to the fall (all P<.01) and persisted throughout the entire year of follow-up. Although nonfaller costs increased with time, faller cohort costs increased more quickly (all P<.01). For admitted fallers, 92% of costs incurred in the quarter of the fall were estimated to be attributable to falling ($27,745 of $30,038, P<.001).

Conclusion: Falls for which medical attention are sought resulted in higher costs than for nonfallers for up to 12 months after a fall, particularly for falls requiring hospitalization. Prevention efforts should focus on reducing fall-related injuries requiring hospitalization because they produce the highest excess costs and have a higher likelihood of 1-year mortality.

Publication types

  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Accidental Falls* / economics
  • Age Factors
  • Aged
  • Aged, 80 and over
  • Comorbidity
  • Female
  • Health Care Costs / statistics & numerical data*
  • Hospitalization
  • Humans
  • Longitudinal Studies
  • Male
  • Sensitivity and Specificity
  • Sex Factors
  • Statistics as Topic
  • Time
  • Washington