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

TitleThe Costs of Fall-Related Injuries among Older Adults: Annual Per-Faller, Service Component, and Patient Out-of-Pocket Costs.
Publication TypeJournal Article
Year of Publication2017
AuthorsHoffman, GJ, Hays, RD, Shapiro, MF, Wallace, SP, Ettner, SL
JournalHealth Serv Res
Date Published2017 10
ISSN Number1475-6773
KeywordsAccidental 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

OBJECTIVE: To estimate expenditures for fall-related injuries (FRIs) among older Medicare beneficiaries.

DATA SOURCES: The 2007-2009 Medicare claims and 2008 Health and Retirement Study (HRS) data for 5,497 (228 FRI and 5,269 non-FRI) beneficiaries.

STUDY DESIGN: FRIs were indicated by inpatient/outpatient ICD-9 diagnostic codes for fractures, trauma, dislocations, and by e-codes. A pre-post comparison group design was used to estimate the differential change in pre-post expenditures for the FRI relative to the non-FRI cohort (FRI expenditures). Out-of-pocket (OOP) costs, service category total annual FRI-related Medicare expenditures, expenditures related to the type of initial FRI treatment (inpatient, ED, outpatient), and the risk of persistently high expenditures (4th quartile for each post-FRI quarter) were estimated.

PRINCIPAL FINDINGS: Estimated FRI expenditures were $9,389 (95 percent CI: $5,969-$12,808). Inpatient, physician/outpatient, skilled nursing facility, and home health comprised 31, 18, 39, and 12 percent of the total. OOP costs were $1,363.0 (95 percent CI: $889-$1,837). Expenditures for FRIs initially treated in inpatient/ED/outpatient settings were $21,424/$6,142/$8,622. The FRI cohort had a 64 percent increased risk of persistently high expenditures. Total Medicare expenditures were $13 billion (95 percent CI: $9-$18 billion).

CONCLUSIONS: FRIs are associated with substantial, persistent Medicare expenditures. Cost-effectiveness of multifactorial falls prevention programs should be assessed using these expenditure estimates.

User Guide Notes

Alternate JournalHealth Serv Res
Citation Key8686
PubMed ID27581952
PubMed Central IDPMC5583303
Grant ListTL1 TR000121 / TR / NCATS NIH HHS / United States
U2C CA186878 / CA / NCI NIH HHS / United States
P20 MD000182 / MD / NIMHD NIH HHS / United States
P30 AG021684 / AG / NIA NIH HHS / United States
T32 HS000046 / HS / AHRQ HHS / United States