Fall-related hospitalizations among elderly Medicare beneficiaries

Accidental falls are a major cause of injury among the elderly, increasing in severity and costs with increasing age. Many accidental falls result in hospitalization for moderate to severe injuries. The latter can greatly increase the risk of mortality. A high percentage of patients hospitalized due to accidental falls are discharged to nursing homes and this percentage increases with age. This study is concerned with determining the characteristics of accidental falls requiring hospitalization, subsequent care needs (especially post-acute care utilization) and care expenditures. MEDPAR inpatient hospital discharge data are examined for Medicare fee-for-service beneficiaries age 65 or over discharged during CY 2004 with any diagnosis of ICD-9-CM codes E880 – E888 (accidental falls) (N=82,341). These hospitalizations are examined by condition, age, race, sex, admission source and discharge destination. Also, length of stay, use of therapy services and total Medicare covered charges are examined. Older beneficiaries and women were more likely to be hospitalized due to a fall in CY 2004. Nearly 40% of fall-related hospitalizations were for hip and femur fractures. Over ¾ of these discharges were admitted through the emergency room. The average length of stay for these hospitalizations was 5.1 days with total Medicare covered charges of $22,065. Nearly 44% of patients hospitalized due to falls were discharged to a skilled nursing facility, 11.6% were discharged to an inpatient rehabilitation facility, and nearly 21% of these patients were discharged to home. While in-hospital mortality was low for most patients, falls resulting in cranial fractures were associated with high mortality.