Using administrative data to track fall-related ambulatory care services in the Veterans Administration Healthcare system.
OBJECTIVE
The Veterans Administration (VA) Healthcare system, containing hospital and community-based outpatient clinics, provides the setting for the study. Summary data was obtained from the VA Ambulatory Events Database for fiscal years (FY) 1997-2001 and in-depth data for FY 2001. In FY 2001, the database included approximately 4 million unique patients with 60 million encounters. The purpose of this study was: 1) to quantify injuries and use of services associated with falls among the elderly treated in Veterans Administration (VA) ambulatory care settings using administrative data; 2) to compare fall-related services provided to elderly veterans with those provided to younger veterans.


METHODS
Retrospective analysis of administrative data. This study describes the trends (FY 1997-2001) and patterns of fall-related ambulatory care encounters (FY 2001) in the VA Healthcare System.


RESULTS
An approximately four-fold increase in both encounters and patients seen was observed in FY 1997-2001, largely paralleling the growth of VA ambulatory care services. More than two-thirds of the patients treated were found to be over the age of 65. Veterans over the age of 65 were found to be more likely to receive care in the non-urgent setting and had higher numbers of co-morbid conditions than younger veterans. While nearly half of the encounters occurred in the Emergency/Urgent Care setting, fall-related injuries led to services across a wide spectrum of medical and surgical providers/departments.


CONCLUSIONS
This study represents the first attempt to use the VA Ambulatory Events Database to study fall-related services provided to elderly veterans. In view of the aging population served by the VA and the movement to provide increased services in the outpatient setting, this database provides an important resource for researchers and administrators interested in the prevention and treatment of fall-related injuries.
Luther
Stephen L
SL
Veterans Integrated Service Network 8, Patient Safety Center of Inquiry, James A. Haley Veterans Administration Medical Center, Tampa, Florida 33612, USA. Steve.Luther@va.gov
French
Dustin D
DD
Powell-Cope
Gail
G
Rubenstein
Laurence Z
LZ
Campbell
Robert
R
D000058:Accidental Falls / Q000191:economics / Q000706:statistics & numerical data*; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000553:Ambulatory Care / Q000458:organization & administration / Q000706:statistics & numerical data*; D003151:Community Health Centers / Q000458:organization & administration / Q000706:statistics & numerical data*; D015897:Comorbidity; D003627:Data Interpretation, Statistical; D016208:Databases, Factual; D004636:Emergency Service, Hospital / Q000458:organization & administration / Q000706:statistics & numerical data*; D005260:Female; D006787:Hospitals, Veterans / Q000458:organization & administration / Q000706:statistics & numerical data; D006801:Humans; D038801:International Classification of Diseases; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D014481:United States / Q000453:epidemiology; D014493:United States Department of Veterans Affairs; D014600:Utilization Review / Q000379:methods