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- Title
The Costs of Fall-Related Injuries among Older Adults: Annual Per-Faller, Service Component, and Patient Out-of-Pocket Costs.
- Authors
Hoffman, Geoffrey J.; Hays, Ron D.; Shapiro, Martin F.; Wallace, Steven P.; Ettner, Susan L.
- Abstract
<bold>Objective: </bold>To estimate expenditures for fall-related injuries (FRIs) among older Medicare beneficiaries.<bold>Data Sources: </bold>The 2007-2009 Medicare claims and 2008 Health and Retirement Study (HRS) data for 5,497 (228 FRI and 5,269 non-FRI) beneficiaries.<bold>Study Design: </bold>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.<bold>Principal Findings: </bold>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).<bold>Conclusions: </bold>FRIs are associated with substantial, persistent Medicare expenditures. Cost-effectiveness of multifactorial falls prevention programs should be assessed using these expenditure estimates.
- Subjects
UNITED States; OLDER people's injuries; MEDICAL care costs; ACCIDENTAL falls in old age; MEDICARE beneficiaries; MEDICAL economics; ECONOMIC impact; MEDICARE; WOUNDS &; injuries; MEDICAL care cost statistics; AGE distribution; ECONOMICS; ACCIDENTAL falls; MEDICAL care; RESEARCH funding; SEX distribution; SOCIOECONOMIC factors; STATISTICAL models
- Publication
Health Services Research, 2017, Vol 52, Issue 5, p1794
- ISSN
0017-9124
- Publication type
journal article
- DOI
10.1111/1475-6773.12554