Online Program

Updated Healthcare Cost Estimates of Fall-Related Injuries Among Older Adults

Tuesday, November 3, 2015

Geoffrey Hoffman, PhD, Department of Health Policy and Management, UCLA Fielding School of Public Health, Los Angeles, CA
Susan Ettner, PhD, David Geffen School of Medicine at UCLA Division of General Internal Medicine & Health Services Research Jonathan and Karin Fielding School of Public Health Department of Health Policy and Management, UCLA, Los Angeles, CA
Ron Hays, PhD, Division of General Internal Medicine and Health Services Research, UCLA, Los Angeles, CA
Martin Shapiro, MD, PhD, Division of General Internal Medicine, UCLA, Los Angeles, CA
Steven Wallace, PhD, Department of Community Health Sciences, UCLA Fielding School of Public Health, Los Angeles, CA
Existing fall-related injury (FRI) cost estimates are dated, inconsistent (ranging from $2,000 to $26,000) and non-generalizable to the U.S., community-dwelling Medicare fee-for-service population.

Using 2007-09 Medicare claims from multiple care settings and linked 2008 Health and Retirement Survey data, FRIs were identified using an adapted UCLA-RAND algorithm with inpatient ICD-9 diagnostic and e-codes (880/881/882/883/884/885/886/888) and a similar algorithm additionally including outpatient diagnostic and CPT codes for procedures and imaging. An FRI cohort included those with a 2008 FRI and no FRIs in the prior, rolling 12-month period. Non-FRI cohort individuals were given a 7/1/2008 index date. The difference in cost changes (post-index minus pre-index costs) between cohorts was estimated to isolate FRI costs. Linear regression models adjusted for sociodemographic characteristics, health status, and geographic factors were specified.

5,548 community-dwelling adults ≥65 (103 FRI and 5,445 non-FRI cohort individuals with continuous Medicare Parts A/B coverage and alive during the 24-month study period.

Unadjusted medical costs during follow-up were $23,429 and $9,818 for FRI and non-FRI cohorts. Adjusted costs for FRIs treated in ED/hospital settings were $14,878 ($6,078 inpatient, $2,644 outpatient/carrier, $5,036 SNF, $1,112 home health) and $11,678 for those treated in inpatient and/or outpatient settings. FRIs increased the risk of high costs in the 4 post-index quarters.

FRIs were associated with substantial and sustained increases in Medicare spending. With roughly 3 million annual FRIs at an approximate additional cost of $12,000-15,000/FRI, estimated Medicare costs due to FRIs were estimated at $45-60 billion.

Learning Areas:

Biostatistics, economics

Learning Objectives:
Describe the healthcare costs of fall-related injuries among U.S. community-dwelling older adults.

Keyword(s): Health Care Costs, Aging

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I have conducted research on aging topics including falls and fall-related injuries and am familiar with the datasets used in this research project.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.