Falls in the Medicare population: incidence, associated factors, and impact on health care.
OBJECTIVE
Falls are a major health problem in the elderly community; however, questions regarding incidence, risk factors, and provider response to falls exist. The purpose of this study was to examine the incidence of falls, associated factors, health care costs, and provider response to falls among Medicare beneficiaries.


METHODS
The participants were 12,669 respondents to the Medicare Current Beneficiaries Survey (MCBS).


METHODS
Categories of number of falls (none, one, recurrent) and injury type (medically injurious versus not medically injurious) were created from the falls supplement to the MCBS. Means and proportions for the entire Medicare population were estimated using sampling weights. The association between sociodemographic variables and fall status was modeled using ordinal or binary logistic regression. Aggregate health costs by fall category were estimated from claims data.


RESULTS
Population estimates of falls reported in 2002 ranged from 3.7 million (single fall) to 3.1 million (recurrent falls), with an estimated 2.2 million people having a medically injurious fall. Recurrent falls were more likely with increased age, being female, being nonwhite, reporting fair or poor health, and increased number of limitations in personal activities of daily living and instrumental activities of daily living and comorbidities. Although estimates of the actual costs of falls could not be determined, "fallers" consistently had larger utilization costs than "nonfallers" for the year 2002. Fewer than half (48%) of the beneficiaries reported talking to a health care provider following a fall, and 60% of those beneficiaries reported receiving fall prevention information.


CONCLUSIONS
Falls are common and may be associated with significant health care costs. Most importantly, health care providers may be missing many opportunities to provide fall prevention information to older people.
Shumway-Cook
Anne
A
Department of Rehabilitation Medicine, University of Washington, Seattle, WA 98195-6490, USA. ashumway@u.washington.edu
Ciol
Marcia A
MA
Hoffman
Jeanne
J
Dudgeon
Brian J
BJ
Yorkston
Kathryn
K
Chan
Leighton
L
D000058:Accidental Falls / Q000191:economics* / Q000706:statistics & numerical data*; D000203:Activities of Daily Living; D000368:Aged; D003710:Demography; D005260:Female; D017048:Health Care Costs / Q000706:statistics & numerical data*; D006801:Humans; D015994:Incidence; D008137:Longitudinal Studies; D008297:Male; D006278:Medicare / Q000706:statistics & numerical data*; D011159:Population Surveillance; D012307:Risk Factors; D014481:United States / Q000453:epidemiology