University of Washington

Department of Rehabilitation Medicine

http://rehab.washington.edu/research/articles/showref.asp?id=4074


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Title:

Longitudinal analysis of total 3-year health care costs for older adults who experience a fall requiring medical care

Author(s):

Bohl, A.A., Fishman, P.A., Ciol, M.A., Williams, B., LoGerfo, J., & Phelan, E.A

Year:

2010

Publication Info:

Journal of the American Geriatrics Society, 58(5):853-860

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.

Link to Article:

http://www.ncbi.nlm.nih.gov/pubmed/20406310


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