Socio-demographic factors predict the likelihood of not returning home after hospital admission following a fall (Gilbert) (original) (raw)
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Background Falls in older people result in a substantial use of resources in the NHS and care homes. One way to reduce the burden would be to identify the factors associated with the likelihood of being discharged to a care home rather than being discharged home after fall-related hospitalization. We investigate the associations between discharge destination after fall-related hospital admission with ecological factors (area deprivation, ethnicity and rurality) and individual level factors (age, gender and co-morbidities).
Injury prevention : journal of the International Society for Child and Adolescent Injury Prevention, 2015
There has been limited research investigating the relationship between injurious falls and hospital resource use. The aims of this study were to identify clusters of community-dwelling older people in the general population who are at increased risk of being admitted to hospital following a fall and how those clusters differed in their use of hospital resources. Analysis of routinely collected hospital admissions data relating to 45 374 fall-related admissions in Victorian community-dwelling older adults aged ≥65 years that occurred during 2008/2009 to 2010/2011. Fall-related admission episodes were identified based on being admitted from a private residence to hospital with a principal diagnosis of injury (International Classification of Diseases (ICD)-10-AM codes S00 to T75) and having a first external cause of a fall (ICD-10-AM codes W00 to W19). A cluster analysis was performed to identify homogeneous groups using demographic details of patients and information on the presence o...
Journal of the American Medical Directors Association, 2019
To the Editor: Falls result in significant morbidity and mortality among older adults and are a concern in ageing populations. There has been evidence that socioeconomic status (SES) predicts postfall outcome; worse postfall survival has been associated with lower education, 1 lower income, 2 and neighborhood deprivation. 2 As a small urbanized country, we were interested to evaluate if SES, at both individual and neighborhood levels, was similarly associated with postfall survival in the older adults of our population. We analyzed a nationally representative retrospective cohort from the Singapore National Trauma Registry (NTR) matched to the death registry. Methods Data Source and Study Design Records for patients aged 55 and above, discharged alive from acute hospitals after suffering residential injurious low falls, were extracted from the NTR (years 2011-2013) and linked to death data (to December 2016). Injurious low falls were defined by moderate or severe injuries (Injury Severity Score !9) and fall heights of up to 0.5 m. Low falls have been shown to be at higher risks of adverse outcomes, 3 and the age cutoff is in line with the literature on the effect of age on trauma outcomes. 4 Analysis was restricted to patients who fell in a residential location as they have higher risks of death than patients who fell outdoors. 5 The inclusion criteria and the processes of data collection, data cleaning, and data quality audit of the NTR have been previously described. 4
Australian and New Zealand Journal of Public Health, 2013
E ach year, the Ambulance Service of New South Wales (ASNSW) attends about 1,120,000 calls, of which almost half are for people aged 65 years and older. Falls in people aged 65 years and older make up 5% of the ASNSW workload, which in 2008/09, represented more than 42,000 service calls. 1 Despite a general policy of routine transportation following attendance, almost 25% of older fallers are not transported to an Emergency Department (ED). Previous research from the United Kingdom (UK) highlighted that non-transported older fallers are a vulnerable population at risk of poor outcomes, including five times the risk of emergency admission to hospital in the following weeks, and of death, compared to the general population of older people. Despite the evidence of increased risk in these older fallers, existing support and direct referral services are limited for this group. 3 It is also recognised that a 100% transportation rate would have a significant impact on hospital EDs, with little evidence to support ED being a better alternative to non-transportation. Identification of factors associated with an increased risk of future falls and repeated health care needs may provide a method for selecting high-risk patients requiring a more detailed assessment linked to evidence-based interventions.
International journal of environmental research and public health, 2017
Falls are serious health problems among older adults, and are the leading cause of fatal and nonfatal injuries treated by emergency medical services (EMS). Although considerable research has examined the risk factors of falls at the individual level, relatively few studies have addressed the risk factors at the neighborhood level. This study examines the characteristics of neighborhood environments associated with fall injuries reported to EMS providers. A total of 13,163 EMS records from 2011 to 2014 involving adults aged 65 and older in the city of San Antonio (TX, USA) were analyzed at the census tract level (n = 264). Negative binomial regression was used to identify significant census tract-based neighborhood environmental variables associated with the count of fall injuries in each census tract. Adjusting for exposure variable and the size of the census tract, neighborhoods with higher residential stability, captured as the percent of those who lived in the same house as the p...
Australian journal of primary health, 2018
Falls are common among older people and a leading cause of injury-related hospitalisation. The immediate post-hospitalisation period is a risky time for further falls. This paper explores discharge strategies from the perspectives of older people hospitalised for a fall and liaison nurses assisting people to return home. Exploratory mixed methods were used. Semi-structured interviews with older people were conducted regarding their experience of the fall and discharge strategies. Quality of life, falls risk and functional capacity were measured by questionnaire. Liaison nurses were also interviewed. Interviews were audio-recorded, transcribed and thematically analysed. Mixed-method synthesis occurred using role-ordered matrix analysis. Older people (n=13) and liaison nurses (n=6) participated. Older persons' quality of life was average and falls risk high. Thematic analysis revealed three key themes: 'falls are not a priority', 'information not given, or given and no...
Hospital and non-hospital costs for fall-related injury in community-dwelling older people
New South Wales Public Health Bulletin, 2008
Falls in older people are common, costly and potentially debilitating. Falls are the leading cause of injury-related hospitalisation and death in people aged 65 years and older, and often result in high economic and social costs. 1,2 Depending on the population under study, between 22 and 60% of fallers suffer injuries from their falls. 3,4 Major injuries including soft tissue damage, head trauma, dislocations and fractures occur in 5 to 15% of all falls in any given year. Furthermore, it has been estimated that 20% of older people who experience a fall sustain injuries that require medical attention. Studies undertaken in Sweden, the United States and the United Kingdom have drawn attention to the significant direct health-care costs required for the treatment of fallrelated injury. 7-12 Two recent studies have used aggregated data to examine the current and projected costs of fall injuries in Australia. 13, One study examined all injury categories and found that fall injuries were the most costly of any injury mechanism. 13 The second study, which was Hospital and non-hospital costs for fall-related injury in community-dwelling older people Abstract: Objectives: This study determined the cost of fall-related health care in a cohort of community-dwelling people. Methods: 578 people aged 75 years and over were monitored for falls and related health-care costs for one year. Results: The mean cost per injurious fall was $1600 (year 2000 dollars). Hospital costs accounted for 67% of the total cost, even though only 4% of injurious falls required hospital admission. The cost of non-hospital health care was also substantial. Conclusion: This study highlights the economic burden of falls and the importance of injury prevention strategies.