The Costs of Fall-Related Injuries among Older Adults: Annual Per-Faller, Service Component, and Patient Out-of-Pocket Costs

Health Services Research

Volumn 52, Issue 5, 2017, Pages 1794-1816

  Hoffman, Geoffrey J ^a   Hays, Ron D ^b,c   Shapiro, Martin F ^b,c   Wallace, Steven P ^c   Ettner, Susan L ^b  

^a UNIVERSITY OF MICHIGAN SCHOOL OF NURSING   (United States)

^b UNIVERSITY OF CALIFORNIA   (United States)

^c UNIVERSITY OF CALIFORNIA   (United States)

Author keywords

direct medical expenditures; elderly; fall related injuries; falls; Medicare

Indexed keywords

ACCIDENTAL INJURY; AGED; ARTICLE; COHORT ANALYSIS; DEMOGRAPHY; DISLOCATION; FALLING; FEMALE; FRACTURE; GENERAL PRACTITIONER; HEALTH CARE COST; HEALTH INSURANCE; HOME CARE; HOSPITAL PATIENT; HUMAN; ICD-9; INJURY; MAJOR CLINICAL STUDY; MALE; MEDICAL FEE; MEDICARE; NURSING HOME; OUT-OF-POCKET COST; OUTPATIENT; RETIREMENT; RISK FACTOR; SENSITIVITY AND SPECIFICITY; AGE; ECONOMICS; FINANCIAL MANAGEMENT; HEALTH SERVICE; SEX DIFFERENCE; SOCIOECONOMICS; STATISTICAL MODEL; STATISTICS AND NUMERICAL DATA; UNITED STATES; UTILIZATION; VERY ELDERLY;

ACCIDENTAL FALLS; AGE FACTORS; AGED; AGED, 80 AND OVER; FEMALE; FINANCING, PERSONAL; HEALTH EXPENDITURES; HEALTH SERVICES; HUMANS; MALE; MEDICARE; MODELS, ECONOMETRIC; SEX FACTORS; SOCIOECONOMIC FACTORS; UNITED STATES; WOUNDS AND INJURIES;

EID: 84992217971     PISSN: 00179124     EISSN: 14756773     Source Type: Journal    
DOI: 10.1111/1475-6773.12554     Document Type: Article

References (55)

1. Alexander, B. H., F. P. Rivara, and M. E. Wolf. 1992. “The Cost and Frequency of Hospitalization for Fall-Related Injuries in Older Adults.” The American Journal of Public Health 82 (7): 1020–3.
2. Annest, J. L., L. A. Fingerhut, S. S. Gallagher, D. C. Grossman, H. Hedegaard, R. L. Johnson, M. Kohn, D. Pickett, K. E. Thomas, and R. B. Trent. 2008. “Strategies to Improve External Cause-of-Injury Coding in State-Based Hospital Discharge and Emergency Department Data Systems: Recommendations of the CDC Workgroup for Improvement of External Cause-of-Injury Coding.” MMWR—Recommendations and Reports 57 (RR-1): 1–15.
3. Blank, W. A., E. Freiberger, M. Siegrist, P. Landendoerfer, K. Linde, T. Schuster, K. Pfeifer, A. Schneider, and M. Halle. 2011. “An Interdisciplinary Intervention to Prevent Falls in Community-Dwelling Elderly Persons: Protocol of a Cluster-Randomized Trial [PreFalls].” BMC Geriatrics 11: 7.
4. Boards of Trustees. 2011. “2011 Annual Report of the Boards of Trustees of the Federal Hospital Insurance and Federal Supplementary Medical Insurance Trust Funds.” The Boards of Trustees, Federal Hospital Insurance and Federal Supplementary Medical Insurance Trust Funds.
5. Bohl, A. A., P. A. Fishman, M. A. Ciol, B. Williams, J. Logerfo, and E. A. Phelan. 2010. “A Longitudinal Analysis of Total 3-year Healthcare Costs for Older Adults Who Experience a Fall Requiring Medical Care.” Journal of the American Geriatrics Society 58 (5): 853–60.
6. Bohl, A. A., E. A. Phelan, P. A. Fishman, and J. R. Harris. 2012. “How Are the Costs of Care for Medical Falls Distributed? The Costs of Medical Falls by Component of Cost, Timing, and Injury Severity.” The Gerontologist 52 (5): 664–75.
7. Boonen, S., P. Autier, M. Barette, D. Vanderschueren, P. Lips, and P. Haentjens. 2004. “Functional Outcome and Quality of Life Following Hip Fracture in Elderly Women: A Prospective Controlled Study.” Osteoporos International 15 (2): 87–94.
8. Carroll, N. V., P. W. Slattum, and F. M. Cox. 2005. “The Cost of Falls among the Community-Dwelling Elderly.” Journal of Managed Care & Specialty Pharmacy 11 (4): 307–16.
9. Carter, M. W., and F. W. Porell. 2011. “The Effect of Sentinel Injury on Medicare Expenditures over Time.” Journal of the American Geriatrics Society 59 (3): 406–16.
10. CMS. 2008. “Medicare Enrollment—Aged Beneficiaries as of July 2008.” Medicare Enrollment Reports [accessed on March 2, 2008]. Available at https://www.cms.gov/Research-Statistics-Data-and-Systems/Statistics-Trends-and-Reports/MedicareEnrpts/Downloads/08Aged.pdf
11. Corso, P., E. Finkelstein, T. Miller, I. Fiebelkorn, and E. Zaloshnja. 2006. “Incidence and Lifetime Costs of Injuries in the United States.” Injury Prevention 12 (4): 212–8.
12. Currie, L. 2008. “Fall and Injury Prevention.” In Patient Safety and Quality: An Evidence-Based Handbook for Nurses, edited by R. G. Hughes, pp. 1–56. Rockville, MD: Agency for Healthcare Research and Quality.
13. Dal Forno, G., P. Chiovenda, F. Bressi, et al. 2006. “Use of an Italian Version of the Telephone Interview for Cognitive Status in Alzheimer's Disease.” International Journal of Geriatric Psychiatry 21 (2): 126–33.
14. Deandrea, S., E. Lucenteforte, F. Bravi, R. Foschi, C. La Vecchia, and E. Negri. 2010. “Risk Factors for Falls in Community-Dwelling Older People: A Systematic Review and Meta-Analysis.” Epidemiology 21 (5): 658–68.
15. Dolan, P., and D. J. Torgerson. 1998. “The Cost of Treating Osteoporotic Fractures in the United Kingdom Female Population.” Osteoporosis International 8 (6): 611–7.
16. Fauth, E. B., S. H. Zarit, B. Malmberg, and B. Johansson. 2007. “Physical, Cognitive, and Psychosocial Variables from the Disablement Process Model Predict Patterns of Independence and the Transition into Disability for the Oldest-Old.” The Gerontologist 47 (5): 613–24.
17. Finkelstein, E., M. Prabhu, and H. Chen. 2007. “Increased Prevalence of Falls among Elderly Individuals with Mental Health and Substance Abuse Conditions.” The American Journal of Geriatric Psychiatry 15 (7): 611–9.
18. Finkelstein, E. A., H. Chen, T. R. Miller, P. S. Corso, and J. A. Stevens. 2005. “A Comparison of the Case-Control and Case-Crossover Designs for Estimating Medical Costs of Nonfatal Fall-Related Injuries among Older Americans.” Medical Care 43 (11): 1087–91.
19. Fleurence, R. L. 2004. “Cost-Effectiveness of Fracture Prevention Treatments in the Elderly.” The International Journal of Technology Assessment in Health Care 20 (2): 184–91.
20. Frick, K. D., J. Y. Kung, J. M. Parrish, and M. J. Narrett. 2010. “Evaluating the Cost-Effectiveness of Fall Prevention Programs that Reduce Fall-Related Hip Fractures in Older Adults.” Journal of the American Geriatrics Society 58 (1): 136–41.
21. Gannon, B., E. O'Shea, and E. Hudson. 2008. “Economic Consequences of Falls and Fractures among Older People.” Irish Medical Journal 101 (6): 170–3.
22. Ganz, D. A., S.-B. Kim, D. S. Zingmond, K. D. Ramirez, C. P. Roth, L. A. Jennings, T. Mori, E. B. Keeler, N. S. Wenger, and D. B. Reuben. 2015. “Effect of a Falls Quality Improvement Program On Serious Fall-Related Injuries.” Journal of the American Geriatrics Society 63 (1): 63–70.
23. Garber, A. M., T. E. MaCurdy, and M. B. McClellan. 1998. “Persistence of Medicare Expenditures among Elderly Beneficiaries.” In Frontiers in Health Policy Research, Vol. 1, edited by A. M. Garber, pp. 153–80. Cambridge, MA: MIT.
24. Gillespie, L. D., M. C. Robertson, W. J. Gillespie, C. Sherrington, S. Gates, L. M. Clemson, and S. E. Lamb. 2012. “Interventions for Preventing Falls in Older People Living in the Community.” Cochrane Database of Systematic Reviews 9: CD007146.
25. Hartholt, K. A., C. Oudshoorn, S. M. Zielinski, P. T. Burgers, M. J. Panneman, E. F. van Beeck, P. Patka, and T. J. van der Cammen. 2011. “The Epidemic of Hip Fractures: Are We on the Right Track?” PLoS ONE 6 (7): e22227.
26. Heinrich, S., K. Rapp, U. Rissmann, C. Becker, and H. H. Konig. 2010. “Cost of Falls in old Age: A Systematic Review.” Osteoporosis International 21 (6): 891–902.
27. Hendrie, D., S. E. Hall, G. Arena, and M. Legge. 2004. “Health System Costs of Falls of Older Adults in Western Australia.” Australian Health Review 28 (3): 363–73.
28. Hendriks, M. R., S. M. Evers, M. H. Bleijlevens, J. C. van Haastregt, H. F. Crebolder, and J. T. van Eijk. 2008. “Cost-Effectiveness of a Multidisciplinary Fall Prevention Program in Community-Dwelling Elderly People: A Randomized Controlled Trial.” The International Journal of Technology Assessment in Health Care 24 (2): 193–202.
29. Hoffman, G. J., R. D. Hays, M. F. Shapiro, S. P. Wallace, and S. L. Ettner. 2016. “Claims-Based Identification Methods and the Cost of Fall-Related Injuries among US Older Adults.” Medical Care 54 (7): 664–71.
30. HRS. 2010. “Health and Retirement Study: 2010 Core Data Description and Usage.” Ann Arbor, MI: University of Michigan.
31. Huang, E. S., A. Basu, M. O'Grady, and J. C. Capretta. 2009. “Projecting the Future Diabetes Population Size and Related Costs for the U.S.” Diabetes Care 32 (12): 2225–9.
32. Inaba, K., M. Goecke, P. Sharkey, and F. Brenneman. 2003. “Long-Term Outcomes after Injury in the Elderly.” The Journal of Trauma 54 (3): 486–91.
33. KFF. 2008. “Medicare Advantage: Total Enrollment.” State Health Facts [accessed on April 1, 2015]. Available at http://kff.org/medicare/state-indicator/total-enrollment-2/
34. Kim, S. B., D. S. Zingmond, E. B. Keeler, L. A. Jennings, N. S. Wenger, D. B. Reuben, and D. A. Ganz. 2016. “Development of an Algorithm to Identify Fall-Related Injuries and Costs in Medicare Data.” Injury Epidemiology 3: 1.
35. Langley, J., S. Stephenson, C. Thorpe, and G. Davie. 2006. “Accuracy of Injury Coding Under ICD-9 for New Zealand Public Hospital Discharges.” Injury Prevention 12 (1): 58–61.
36. LeMier, M., P. Cummings, and T. A. West. 2001. “Accuracy of External Cause of Injury Codes Reported in Washington State Hospital Discharge Records.” Injury Prevention 7 (4): 334–8.
37. Mahoney, J. E., R. L. Glysch, S. M. Guilfoyle, L. J. Hale, and M. L. Katcher. 2005. “Trends, Risk Factors, and Prevention of Falls in Older Adults in Wisconsin.” Wisconsin Medical Society 104 (1): 22–8.
38. Martin, L. G., V. A. Freedman, R. F. Schoeni, and P. M. Andreski. 2009. “Health and Functioning among Baby Boomers Approaching 60.” The Journals of Gerontology. Series B, Psychological Sciences and Social Sciences 64 (3): 369–77.
39. McKenzie, K., E. L. Enraght-Moony, S. M. Walker, R. J. McClure, and J. E. Harrison. 2009. “Accuracy of External Cause-of-Injury Coding in Hospital Records.” Injury Prevention 15 (1): 60–4.
40. Owens, P. L., C. A. Russo, W. Spector, and R. Mutter. 2009. Healthcare Cost and Utilization (HCUP) Statistical Brief #80: Emergency Department Visits for Injurious Falls among the Elderly, 2006. Rockville, MD: Agency for Health Care Policy and Research.
41. Quigley, P. A., R. R. Campbell, T. Bulat, R. L. Olney, P. Buerhaus, and J. Needleman. 2012. “Incidence and Cost of Serious Fall-Related Injuries in Nursing Homes.” Clinical Nursing Research 21 (1): 10–23.
42. RAND. 2003. Falls Prevention Interventions in the Medicare Population. Baltimore, MD: The RAND Corporation, prepared for the U.S. Department of Health and Human Services.
43. Rice, T., and K. Y. Matsuoka. 2004. “The Impact of Cost-Sharing on Appropriate Utilization and Health Status: A Review of the Literature on Seniors.” Medical Care Research and Review 61 (4): 415–52.
44. Richmond, T. S., D. Kauder, N. Strumpf, and T. Meredith. 2002. “Characteristics and Outcomes of Serious Traumatic Injury in Older Adults.” Journal of the American Geriatrics Society 50 (2): 215–22.
45. Rizzo, J. A., R. Friedkin, C. S. Williams, J. Nabors, D. Acampora, and M. E. Tinetti. 1998. “Health Care Utilization and Costs in a Medicare Population by Fall Status.” Medical Care 36 (8): 1174–88.
46. Roudsari, B. S., B. E. Ebel, P. S. Corso, N. A. Molinari, and T. D. Koepsell. 2005. “The Acute Medical Care Costs of Fall-Related Injuries among the U.S. Older Adults.” Injury 36 (11): 1316–22.
47. Rubenstein, L. Z., and K. R. Josephson. 2002. “The Epidemiology of Falls and Syncope.” Clinics in Geriatric Medicine 18 (2): 141–58.
48. Scuffham, P., S. Chaplin, and R. Legood. 2003. “Incidence and Costs of Unintentional Falls in Older People in the United Kingdom.” Journal of Epidemiology and Community Health 57 (9): 740–4.
49. Shumway-Cook, A., M. A. Ciol, J. Hoffman, B. J. Dudgeon, K. Yorkston, and L. Chan. 2009. “Falls in the Medicare Population: Incidence, Associated Factors, and Impact on Health Care.” Physical Therapy 89 (4): 324–32.
50. Stevens, J. A., P. S. Corso, E. A. Finkelstein, and T. R. Miller. 2006. “The Costs of Fatal and Non-Fatal Falls among Older Adults.” Injury Prevention 12 (5): 290–5.
51. Takanishi Jr, D. M., M. Yu, and S. Y. Morita. 2008. “Increased Fatalities and Cost of Traumatic Injuries in Elderly Pedestrians in Hawaii: A Challenge for Prevention and Outreach.” Asia Pacific Journal of Public Health 20 (4): 327–39.
52. Tinetti, M. E., M. Speechley, and S. F. Ginter. 1988. “Risk Factors for Falls among Elderly Persons Living in the Community.” The New England Journal of Medicine 319 (26): 1701–7.
53. Tinetti, M. E., C. Gordon, E. Sogolow, P. Lapin, and E. H. Bradley. 2006. “Fall-Risk Evaluation and Management: Challenges in Adopting Geriatric Care Practices.” The Gerontologist 46 (6): 717–25.
54. Verma, S. K., J. L. Willetts, H. L. Corns, H. R. Marucci-Wellman, D. A. Lombardi, and T. K. Courtney. 2016. “Falls and Fall-Related Injuries among Community-Dwelling Adults in the United States.” PLoS ONE 11 (3): e0150939.
55. Wu, S., E. B. Keeler, L. Z. Rubenstein, M. A. Maglione, and P. G. Shekelle. 2010. “A Cost-Effectiveness Analysis of a Proposed National Falls Prevention Program.” Clinics in Geriatric Medicine 26 (4): 751–66.