The high cost to health and social care of managing falls in older adults living in the community in Scotland.
OBJECTIVE
Estimate costs for health and social care services in managing older people in the community who fall.


RESULTS
Analyses of predominantly national databases using cost of illness methodologies. In Scotland, 294,000 (34%) of people over 65 years and living in the community fall at least once a year. Of these 20%, almost 60,000 people contacted a medical service for assistance. There were almost 30,000 attendances at GP practices, over 36,100 calls to the Scottish Ambulance Service and 46,816 people presenting at A&E, with 16,549 admitted, 30% with a hip fracture. Mortality was high, 7% during the hospital stay, rising to over 12% at 1 year. Over 20% of patients were unable to return to their homes. Associated costs were over £470 million, with 60% incurred by social services, mainly providing long-term care. Cost per person falling was over £1720, rising to over £8600 for those seeking medical assistance. A hip fracture admission cost £39,490, compared with £21,960 for other falls-related admissions.


CONCLUSIONS
Transparent, robust cost information demonstrates the substantial burden of falls for health and social care services and should be a driver for implementing evidence-based interventions to reduce falls.
Project Director, York Health Economics Consortium, University of York, UK.
J
J
Craig
A
A
Murray
S
S
Mitchell
S
S
Clark
L
L
Saunders
L
L
Burleigh
D000058:Accidental Falls / Q000191:economics* / Q000706:statistics & numerical data; D000368:Aged; D000369:Aged, 80 and over; D017281:Cost of Illness; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data; D005260:Female; D006078:Government Programs; D017048:Health Care Costs / Q000706:statistics & numerical data*; D006299:Health Services for the Aged / Q000191:economics*; D006620:Hip Fractures / Q000191:economics / Q000628:therapy; D006760:Hospitalization; D006801:Humans; D015994:Incidence; D057187:Independent Living; D008297:Male; D011314:Preventive Health Services / Q000191:economics*; D012606:Scotland / Q000453:epidemiology; D013222:State Medicine / Q000191:economics*; D014947:Wounds and Injuries / Q000191:economics* / Q000453:epidemiology / Q000628:therapy
Costs; community; falls; older people