Premium
The Costs of Fall‐Related Injuries among Older Adults: Annual Per‐Faller, Service Component, and Patient Out‐of‐Pocket Costs
Author(s) -
Hoffman Geoffrey J.,
Hays Ron D.,
Shapiro Martin F.,
Wallace Steven P.,
Ettner Susan L.
Publication year - 2017
Publication title -
health services research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.706
H-Index - 121
eISSN - 1475-6773
pISSN - 0017-9124
DOI - 10.1111/1475-6773.12554
Subject(s) - medicine , quartile , cohort , diagnosis code , inpatient care , demography , emergency medicine , health care , gerontology , environmental health , confidence interval , population , sociology , economics , economic growth
Objective To estimate expenditures for fall‐related injuries ( FRI s) among older Medicare beneficiaries. Data Sources The 2007–2009 Medicare claims and 2008 Health and Retirement Study ( HRS ) data for 5,497 (228 FRI and 5,269 non‐ FRI ) beneficiaries. Study Design FRI s 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. Principal Findings 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 FRI s 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). Conclusions FRI s are associated with substantial, persistent Medicare expenditures. Cost‐effectiveness of multifactorial falls prevention programs should be assessed using these expenditure estimates.