title: The cost of emergency hospital admissions for falls on snow and ice in England during winter 2009/10: a cross sectional analysis.
abstract: BACKGROUND
  In the UK, the 2009/10 winter was characterised by sustained low temperatures; grit stocks became depleted and surfaces left untreated. We describe the relationship between temperature and emergency hospital admissions for falls on snow and ice in England, identify the age and gender of those most likely to be admitted, and estimate the inpatient costs of these admissions during the 2009/10 winter.
  
  
  METHODS
  Hospital Episode Statistics were used to identify episodes of emergency admissions for falls on snow and ice during winters 2005/06 to 2009/10; these were plotted against mean winter temperature. By region, the logs of the rates of weekly emergency admissions for falls on snow and ice were plotted against the mean weekly temperature for winters 2005/06 to 2009/10 and a linear regression analysis undertaken. For the 2009/10 winter the number of emergency hospital admissions for falls on snow and ice were plotted by age and gender. The inpatient costs of admissions in the 2009/10 winter for falls on snow and ice were calculated using Healthcare Resource Group costs and Admitted Patient Care 2009/10 National Tariff Information.
  
  
  RESULTS
  The number of emergency hospital admissions due to falls on snow and ice varied considerably across years; the number was 18 times greater in 2009/10 (N = 16,064) than in 2007/08 (N = 890). There is an exponential increase [Ln(rate of admissions) = 0.456 - 0.463*(mean weekly temperature)] in the rate of emergency hospital admissions for falls on snow and ice as temperature falls. The rate of admissions in 2009/10 was highest among the elderly and particularly men aged 80 and over. The total inpatient cost of falls on snow and ice in the 2009/10 winter was 42 million GBP.
  
  
  CONCLUSIONS
  Emergency hospital admissions for falls on snow and ice vary greatly across winters, and according to temperature, age and gender. The cost of these admissions in England in 2009/10 was considerable. With responsibility for health improvement moving to local councils, they will have to balance the cost of public health measures like gritting with the healthcare costs associated with falls. The economic burden of falls on snow and ice is substantial; keeping surfaces clear of snow and ice is a public health priority.
authors.affiliation: North West Public Health Observatory, Liverpool John Moores University, UK. C.M.Beynon@ljmu.ac.uk
authors.forename: Caryl
authors.initials: C
authors.lastname: Beynon
authors.forename: Sacha
authors.initials: S
authors.lastname: Wyke
authors.forename: Ian
authors.initials: I
authors.lastname: Jarman
authors.forename: Mark
authors.initials: M
authors.lastname: Robinson
authors.forename: Jenny
authors.initials: J
authors.lastname: Mason
authors.forename: Karen
authors.initials: K
authors.lastname: Murphy
authors.forename: Mark A
authors.initials: MA
authors.lastname: Bellis
authors.forename: Clare
authors.initials: C
authors.lastname: Perkins
mesh_terms: D000058:Accidental Falls / Q000191:economics* / Q000706:statistics & numerical data; D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D004636:Emergency Service, Hospital / Q000191:economics / Q000706:statistics & numerical data; D004739:England / Q000453:epidemiology; D005260:Female; D017048:Health Care Costs; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D012621:Seasons; D012737:Sex Factors; D012914:Snow; D014947:Wounds and Injuries / Q000191:economics / Q000453:epidemiology; D055815:Young Adult