sábado, 21 de febrero de 2015

CDC - Older Adult Falls - Costs of Falls Among Older Adults - Home and Recreational Safety - Injury Center

CDC - Older Adult Falls - Costs of Falls Among Older Adults - Home and Recreational Safety - Injury Center

Did You Know?

patient using walker

  • Every year, one in three people aged 65 or older experiences a fall, which is the leading cause of both fatal and nonfatal injuries among older adults.
  • Falls among older adults cost the US $30 billion a year in direct medical expenses.
  • A new study finds that community-based fall prevention programs are feasible and effective and save money.

Costs of Falls Among Older Adults

In 2012, the direct medical costs of older adult falls, adjusted for inflation, were $30 billion.1 With the population aging, both the number of falls and the costs to treat fall injuries are likely to increase.

How big is the problem?

  • One in three adults aged 65 and older falls each year.2 Of those who fall, 20% to 30% suffer moderate to severe injuries that make it hard for them to get around or live independently, and increase their risk of early death.3
  • Older adults are hospitalized for fall-related injuries five times more often than they are for injuries from other causes.4
  • In 2012, emergency departments treated 2.4 million nonfatal fall injuries among older adults; more than 722,000 of these patients had to be hospitalized.5

How are costs calculated?

The costs of fall-related injuries are often shown in terms of direct costs.
  • Direct costs are what patients and insurance companies pay for treating fall-related injuries. These costs include fees for hospital and nursing home care, doctors and other professional services, rehabilitation, community-based services, use of medical equipment, prescription drugs, changes made to the home, and insurance processing.
  • Direct costs do not account for the long-term effects of these injuries such as disability, dependence on others, lost time from work and household duties, and reduced quality of life.

How costly are fall-related injuries among older adults?

Photo: older adult man with doctor
  • In 2012, the total direct medical costs of fall injuries for people 65 and older, adjusted for inflation, was $30 billion.1
  • By 2020, the annual direct and indirect cost of fall injuries is expected to reach $67.7 billion (in 2012 dollars).6
  • Among community-dwelling older adults, fall-related injury is one of the 20 most expensive medical conditions.7
  • In 2002, about 22% of community-dwelling seniors reported having fallen in the previous year. Medicare costs per fall averaged between $13,797 and $20,450 (in 2012 dollars).8
  • Among community-dwelling seniors treated for fall injuries, 65% of direct medical costs were for inpatient hospitalizations; 10% each for medical office visits and home health care, 8% for hospital outpatient visits, 7% for emergency room visits, and 1% each for prescription drugs and dental visits. About 78% of these costs were reimbursed by Medicare.9
  • In a 1998 study of people age 72 and older, the average health care cost of a fall injury totaled $19,440, which included hospital, nursing home, emergency room, and home health care, but not doctors’ services.10

How do these costs break down?

Age and sex

  • The costs of fall injuries increase rapidly with age.1
  • Costs of both fatal and nonfatal falls are higher for women than for men.1
  • In 2000, medical costs for women, who comprised 58% of older adults, were two to three times higher than the costs for men.1

Type of injury and treatment setting

  • In 2000, 78% of fall deaths, and 79% of total costs, were due to traumatic brain injuries (TBI) and injuries to the lower extremities.1
  • Injuries to internal organs were responsible for 28% of fall deaths and accounted for 29% of costs.6
  • Fractures were both the most common and most costly nonfatal injuries. Just over one-third of nonfatal injuries were fractures, but these accounted for 61% of total nonfatal costs—or $18.8 billion (in 2012 dollars).1
  • Hospitalizations accounted for nearly two-thirds of the costs of nonfatal fall injuries and emergency department treatment accounted for 20%.1
  • On average, the hospitalization cost for a fall injury is $34,294 (in 2012 dollars).11
  • Hip fractures are the most serious and costly fall-related fracture. Hospitalization costs account for 44% of the  direct medical costs for hip fractures.12


  1. Stevens JA, Corso PS, Finkelstein EA, Miller TR. The costs of fatal and nonfatal falls among older adults. Injury Prevention 2006a;12:290–5.
  2. Tromp AM, Pluijm SMF, Smit JH, et al. Fall-risk screening test: a prospective study on predictors for falls in community-dwelling elderly. J Clin Epidemiol 2001;54(8):837–844.
  3. Sterling DA, O'Connor JA, Bonadies J. Geriatric falls: injury severity is high and disproportionate to mechanism. Journal of Trauma–Injury, Infection and Critical Care 2001;50(1):116–9.
  4. Alexander BH, Rivara FP, Wolf ME. The cost and frequency of hospitalization for fall-related injuries in older adults. American Journal of Public Health 1992;82(7):1020–3.
  5. Centers for Disease Control and Prevention, National Center for Injury Prevention and Control. Web–based Injury Statistics Query and Reporting System (WISQARS) [online]. Accessed November 30, 2010.
  6. Englander F, Hodson TJ, Terregrossa RA. Economic dimensions of slip and fall injuries. Journal of Forensic Science 1996;41(5):733–46.trial. The Gerontologist 1994;34(1):16–23.
  7. Stevens JA, Corso PS, Finkelstein EA, Miller TR. The costs of fatal and nonfatal falls among older adults. Injury Prevention 2006;12:290–5.
  8. Shumway-Cook A, Ciol MA, Hoffman J, Dudgeon BJ, Yorston K, Chan L. Falls in the Medicare population: incidence, associated factors, and impact on health care. Physical Therapy 2009.89(4):1-9.
  9. Carroll NV, Slattum PW, Cox FM. The cost of falls among the community-dwelling elderly. Journal of Managed Care Pharmacy. 2005;11(4):307-16.
  10. Rizzo JA, Friedkin R, Williams CS, Nabors J, Acampora D, Tinetti ME. Health care utilization and costs in a Medicare population by fall status. Medical Care 1998;36(8):1174–88.
  11. Roudsari BS, Ebel BE, Corso PS, Molinari, NM, Koepsell TD. The acute medical care costs of fall-related injuries among the U.S. older adults. Injury, Int J Care Injured 2005;36:1316-22.
  12. Barrett-Connor E. The economic and human costs of osteoporotic fracture. American Journal of Medicine 1995;98(suppl 2A):2A–3S to 2A–8S.

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