Western Journal of Emergency Medicine: Integrating Emergency Care with Population Health
Trends and Characteristics of Emergency Department Visits for Fall-Related Injuries in Older Adults, 2003-2010
- Author(s): Shankar, Kalpana N.
- Ganz, David A.
- Liu, Shan W.
- et al.
Published Web Locationhttps://doi.org/10.5811/westjem.2017.5.33615
Introduction: One third of older adults fall each year, and falls are costly to both the patient in terms ofmorbidity and mortality and to the health system. Given that falls are a preventable cause of injury, ourobjective was to understand the characteristics and trends of emergency department (ED) fall-relatedvisits among older adults. We hypothesize that falls among older adults are increasing and examinepotential factors associated with this rise, such as race, ethnicity, gender, insurance and geography.
Methods: We conducted a secondary analysis of data from the National Hospital AmbulatoryMedical Care Survey (NHAMCS) to determine fall trends over time by examining changes in EDvisit rates for falls in the United States between 2003 and 2010, detailing differences by gender,sociodemographic characteristics and geographic region.
Results: Between 2003 and 2010, the visit rate for falls and fall-related injuries among people age≥ 65 increased from 60.4 (95% confidence interval [CI][51.9-68.8]) to 68.8 (95% CI [57.8-79.8]) per1,000 population (p=0.03 for annual trend). Among subgroups, visits by patients aged 75-84 yearsincreased from 56.2 to 82.1 per 1,000 (P <.01), visits by women increased from 67.4 to 81.3 (p =0.04), visits by non-Hispanic Whites increased from 63.1 to 73.4 (p < 0.01), and visits in the Southincreased from 54.4 to 71.1 (p=0.03).
Conclusion: ED visit rates for falls are increasing over time. There is a national movement toincrease falls awareness and prevention. EDs are in a unique position to engage patients on futurefall prevention and should consider ways they can also partake in such initiatives in a manner that isfeasible and appropriate for the ED setting. [West J Emerg Med. 2017;18(5)785-793.]