Friday, March 09, 2018 Study: Falls Among US Adults 65 and Older Cost $50 Billion in 2015 The US health care system spent an estimated $50 billion on falls in 2015, an amount representing 6% of all Medicare payments and 8% of all Medicaid payments, according to a new study. Authors say that unless the US steps up its game when it comes to falls risk assessment and prevention, costs are certain to climb steadily higher as the baby boomer generation continues to age. Researchers based their estimates on data from the Medicare Current Beneficiaries Survey (MCBS), then applied these data to data from the National Health Expenditures Accounts (NHEA) to estimate nonfatal falls expense. For fata falls, they used the Web-based Injury Statistics Query and Reporting System (WISQARS) to assess expense. The final MCBS sample included 3,460 community-dwelling individuals 65 and older. Respondents who were employed, died during the survey period, or lived in Puerto Rico were excluded. Results of the study were published in the Journal of the American Geriatrics Society. Among the findings: Based on the survey, researchers estimate total 2015 health care expenditures for nonfatal falls in the US at $49.5 billion--$28.9 billion for Medicare, $8.7 billion for Medicaid, and $12 billion for other payment sources including private insurance and out-of-pocket expense. Nearly 1 in 4 adults in the survey reported a fall in the past year. Of those, 52.1% fell once, 21.3% fell twice, and 24.1% fell 3 or more times. Individuals who reported falls had significantly lower self-rated health and more chronic conditions, and were more likely to be female, white, and from lower income levels. Estimated costs were not distributed equally among service types, with an "other" category—spending in areas such as home health services, long-term care facilities, and durable medical equipment—leading the way at $29.2 billion. That amount was more than double hospital-related spending, which was second at $12.9 billion, followed by physician/other provider spending ($10.8 billion), prescription drugs ($2.1 billion), and dental ($400 million). Unintentional fall deaths were recorded at a rate of 59.64 per 100,000 population in 2015, with associated medical costs of $754 million—about 1% of the total estimated expenditures. Overall, spending on falls in 2015 increased by nearly 32% from 2013, when total spending was estimated at $38 billion. "The economic burden from falls is likely to increase substantially in the coming years," authors write. "Monitoring cost trends is important, because 75% of the cost of older adult falls is financed through public health insurance programs that are already financially stressed." Authors believe that given the undeniable demographic pressure that will increase as baby boomers age, it's imperative that more attention be given to falls assessment and prevention. "Preventive strategies that reduce falls in older adults could lead to a substantial reduction in health care spending," authors write. The researchers stress that "evidence-based strategies including medication management and strength and balance exercises…have been associated with reductions in older adult falls," and point to guidelines such as those included in the US Centers for Disease Control and Prevention's Stopping Elderly Accidents, Deaths, and Injuries (STEADI) initiative as a good place to start But there's no time to lose, they add. Authors of the study believe that providers need to act with urgency and do a better job of identifying falls risk, assessing which risk factors may be modified and providing evidence-based interventions to decrease that risk. "Clinical care is an important component of falls prevention," they write. "By broadly implementing and scaling up initiatives like STEADI, we can improve health and decrease the future economic burden of older adult falls." Research-related stories featured in PT in Motion News are intended to highlight a topic of interest only and do not constitute an endorsement by APTA. For synthesized research and evidence-based practice information, visit the association's PTNow website. Editor's note: Want more on falls prevention? Check out the falls-related resources at PTNow, including a unilateral vestibular hypofunction clinical summary, a summary on falls risk in community-dwelling elders, an osteoporosis clinical summary, and tests and measures such as a fracture risk assessment, a clinical test of sensory interaction and balance, and a self-paced walk test. APTA also offers resources on its Balance and Falls webpage.