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Cost of U.S emergency department and inpatient visits for fall injuries in older adults
Journal article   Open access   Peer reviewed

Cost of U.S emergency department and inpatient visits for fall injuries in older adults

Lisa Reider, Jason R. Falvey, Safiyyah M. Okoye, Jennifer L. Wolff and Joseph F. Levy
Injury, v 55(2), pp 111199-111199
01 Feb 2024
DOI: https://doi.org/10.1016/j.injury.2023.111199
PMID: 38006782
Featured in Collection :   UN Sustainable Development Goals @ Drexel
url
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11829734View
Accepted (AM)Open Access (License Unspecified),  Open

Abstract

Emergency department cost Fall injury Fracture Inpatient cost Geriatrics
Background: Falls are a leading cause of injury and hospital readmissions in older adults. Understanding the distribution of acute treatment costs across inpatient and emergency department settings is critical for informed investment and evaluation of fall prevention efforts. Methods: This study used the 2016–2018 National Inpatient Sample and National Emergency Department Sample. Annual treatment cost of fall injury among adults 65 years and older was estimated from charges, applying cost-to-charge and professional fee ratios. Weighted multivariable generalized linear models were used to separately estimate cost for inpatient and emergency department (ED) setting by injury type and individual demographic and health characteristics after adjusting for payer and hospital level characteristics. Results: Older adults incurred an estimated 922,428 inpatient and 2.3 million ED visits annually due to falls with combined annual costs of $19.8 billion. Over half of inpatient visits for fall injury were for fracture. Notably, 23% of inpatient visits were for fractures other than hip fracture and 14% of inpatient visits were for multiple fractures with costs totaling $3.4 billion and $2.5 billion, respectively. Annual ED costs were driven by superficial injury totaling $1.5 billion. Cost of ED visits were higher for adults 85 years and older (adjusted cost ratio (aCR): 1.11, 95% Confidence Interval (CI)I: 1.11–1.12) and those with dementia (aCR: 1.14, 95% CI: 1.13–1.15). Higher inpatient and ED visit cost was also associated with high-energy falls and discharge to post-acute care. Conclusion: The study found that more than 3 million older adults in the United States seek hospital care for fall injuries annually, a major concern given increasing capacity strain on hospitals and EDs. The $20 billion in annual acute treatment costs attributed to fall injury indicate an urgent need to implement evidence-based fall prevention interventions and underscores the importance of newly launched ED-based fall prevention efforts and investments in geriatric emergency departments.

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35 citations in Web of Science
23 citations in Scopus

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UN Sustainable Development Goals (SDGs)

This publication has contributed to the advancement of the following goals:

#3 Good Health and Well-Being

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Collaboration types
Domestic collaboration
Web of Science research areas
Critical Care Medicine
Emergency Medicine
Orthopedics
Surgery
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