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ED Visits for Injurious Falls in the Elderly

Posted Nov 10 2009 10:02pm
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The Agency for Healthcare Research and Quality ( AHRQ ) reports results from analyses of the Healthcare Cost and Utilization Project-Nationwide Emergency Department Sample regarding ED visits among elderly adults who were coded as sustaining both a fall and an injury.  Starting from the vantage point of the ED these analyses highlight the importance of our efforts to reduce falls and illuminate how injurious falls contribute to human suffering, ED overcrowding, hospital costs, admission to long term care facilities as well as private and government health care spending.  Having sustained a fall injury requiring a trip to the ED could trigger efforts to identify, track, assess and intervene with these high risk individuals in order to reduce the risk of sustaining another fall. Having fallen is one of the strongest predictors that one will fall again.

In the United States in calendar year 2006:

Injurious falls accounted for 10.5% of all ED visits among adults aged 65+, totaling over 2.1 million visits.

  • The rate was 57.4 ED visits for injurious fall injury per 1000 people 65+ years of age.
  • Females accounted for 70.2% of the ED visits.  Those aged 75-84 had the highest number of visits (40.3%), followed by those 85+ (32.4%) and finally those 65-74 (27.3%).  Nearly 1 in 7 women and 1 in 10 men aged 85+ had an ED visit for an injurious fall.
  • The most common injuries resulting in an ED visit were fractures (41%); superficial contusions (22.6%); open wounds (21.4%), sprains and strains (10%); internal organ injuries (4.6%) and dislocations (1.5%).
  • Hip fractures accounted for about 1 in 8 ED visits among adults aged 65+.
  • Nearly 30% of the injurious falls treated in the ED resulted in hospital admissions and these admissions (while not longer) had a higher average cost ($10,800) relative to older adults admitted from the ED for other reasons ($9,900).
  • The aggregate national cost of hospital care for older adults who came in through the ED for an injurious fall was $6.8 billion.
  • The elderly who were treated in the ED for an injurious fall and then hospitalized were more likely to be discharged to long term care (65.7%) than elderly ED patients hospitalized for other reasons (28.4%). Fractures or internal injuries were most likely to require hospital discharge to a long term care facility.

Owens PL, Russo CA, Spector W and Mutter R. Emergency department visits for injurious falls among the elderly, 2006.

HCUP Statistical Brief #80.  October 2009.  Agency for Healthcare Research and Quality, Rockville, Maryland.

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