The Financial Cost of Falls among Older Adults
In 2000, falls among older adults cost the U.S. health care system over $19 billion dollars. 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 age 65 and older falls each year.
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.
Older adults are hospitalized for fall-related injuries five times more often than they are for injuries from other causes.
In 2009, emergency departments treated 2.2 million nonfatal fall injuries among older adults; more than 582,000 of these patients had to be hospitalized.
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?

In 2000, the total direct medical costs of all fall injuries for people 65 and older exceeded $19 billion: $0.2 billion for fatal falls, and $19 billion for nonfatal falls.
By 2020, the annual direct and indirect cost of fall injuries is expected to reach $54.9 billion (in 2007 dollars).
Among community-dwelling older adults, fall-related injury is one of the 20 most expensive medical conditions.
In 2002, about 22% of community-dwelling seniors reported falling in the previous year. Medicare costs per fall averaged between $9,113 and $13,507.
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.
In a 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.

How do these costs break down?

Age and sex

The costs of fall injuries increase rapidly with age.
In 2000, the costs of both fatal and nonfatal falls were higher for women than for men.
Medical costs in 2000 for women, who comprised 58% of older adults, were two to three times higher than for men.
Type of injury and treatment setting

In 2000, traumatic brain injuries (TBI) and injuries to the hips, legs, and feet were the most common and costly fatal fall injuries, and accounted for 78% of fatalities and 79% of costs.
Injuries to internal organs caused 28% of deaths and accounted for 29% of costs from fatal falls.
Fractures were both the most common and most costly type of nonfatal injuries. Just over one-third of nonfatal injuries were fractures, but they accounted for 61% of costs—or $12 billion.
Hospitalizations accounted for nearly two-thirds of the costs of nonfatal fall injuries, and emergency department treatment accounted for 20%.
On average, the hospitalization cost for a fall injury is $17,500.
Hip fractures are the most frequent type of fall-related fractures. The cost of hospitalization for hip fracture averaged about $18,000. Hospitalization costs accounted for 44% of direct medical costs for hip fractures.
Content source: Centers for Disease Control and Prevention, National Center for Injury Prevention and Control, Division of Unintentional Injury Prevention

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