The Potential to Reduce Falls and Avert Costs by Clinically Managing Fall Risk

Judy A. Stevens, PhD

Robin Lee, PhD, MPH

Correspondence information about the author PhD, MPH Robin Lee

Email the author PhD, MPH Robin Lee

This activity is available for CME credit. See page A3 for information.

DOI: https://doi.org/10.1016/j.amepre.2018.04.035

Article Outline

Introduction

Falls often cause severe injuries and are one of the most costly health conditions among older adults. Yet, many falls are preventable. The number of preventable medically treated falls and associated costs averted were estimated by applying evidence-based fall interventions in clinical settings.

Methods

A review of peer-reviewed literature was conducted in 2017 using literature published between 1994 and 2017, the authors estimated the prevalence of seven fall risk factors and the effectiveness of seven evidence-based fall interventions. Then authors estimated the number of older adults (aged ≥65 years) who would be eligible to receive one of seven fall interventions (e.g., Tai Chi, Otago, medication management, vitamin D supplementation, expedited first eye cataract surgery, single-vision distance lenses for outdoor activities, and home modifications led by an occupational therapist). Using the reported effectiveness of each intervention, the number of medically treated falls that could be prevented and the associated direct medical costs averted were calculated.

Results

Depending on the size of the eligible population, implementing a single intervention could prevent between 9,563 and 45,164 medically treated falls and avert $94–$442 million in direct medical costs annually. The interventions with the potential to help the greatest number of older adults were those that provided home modification delivered by an occupational therapist (38.2 million), and recommended daily vitamin D supplements (16.7 million).

Conclusions

This report is the first to estimate the number of medically treated falls that could be prevented and the direct medical costs that could be adverted. Preventing falls can benefit older adults substantially by improving their health, independence, and quality of life.

Potential to Reduce Older Adult Falls and Avert Costs

Implementing a clinical fall prevention program – including screening for fall risk, assessing potential risk factors, and intervening to reduce identified risk – can reduce the number of older adults who fall, and avert sizable healthcare costs. More than 1 out of 4 Americans 65 and older fall each year, resulting in over 3 million emergency department visits annually. The estimated medical cost from these falls is approximately $50 billion annually.

A recent study published in the American Journal of Preventive Medicine (AJPM) found that clinically identifying and managing fall risk factors could prevent as many as 45,164 medically treated falls and avert up to $442 million in direct medical costs annually.

The report, titled “The Potential to Reduce Falls and Avert Costs by Clinically Managing Fall Risk,” looked at the population-level impact of seven evidence-based interventions on reducing falls and lowering direct medical costs among community-dwelling older adults. More than 90% of older adults see a medical provider at least once a year, giving clinicians the opportunity to inform and empower older adults to address one or more specific fall risk factors.

Clinicians can obtain continuing medical education (CME) for reading this select article through AJPM’s CME program.

STEADI Resources

CDC’s Stopping Elderly Accidents, Deaths, and Injuries, or STEADI initiative, includes resources and tools to help members of the healthcare team (e.g., physicians, nurses, pharmacists, occupational therapists, physical therapists) integrate fall prevention into their clinical practice. The resources include:

The Potential to Reduce Falls and Avert Costs by Clinically Managing Fall Risk - American Journal of Preventive Medicine