Trends in fall-related hospitalisations in older people living in aged care facilities.
The aim is to describe the trends in fall-related hospitalisations for older people living in aged care facilities. Over the 9-year period investigated, there were dramatic increases in fall-related hospitalisations. This worrying trend highlights that we may not be addressing falls in aged care facilities sufficiently.


BACKGROUND
The purposes of this study are to describe the trends in fall-related hospitalisations in older people living in aged care facilities and to compare these trends across different demographic groups and injury types.


METHODS
This study was conducted in Australia's second most populous state, Victoria. Aged care facilities in Australia provide high- and low-level nursing care for people who can no longer live independently. Included in this study were hospital admitted episodes of care which met the following criteria: age 65+ years at admission, an admission source indicating a transfer from an aged care facility, an external cause indicating a fall, a care type of 'acute', a Victorian postcode of residence, and an admission date between July 1, 2003 and June 30, 2012 (inclusive). Rate denominator data were Victorian aged care bed years.


RESULTS
Over the last 9 years, 7098 episodes of care met the inclusion criteria. The age-standardised rate of hospitalisation increased by 11% (95% confidence interval [CI] 9%, 12%) per year. Serious injury increased at a slower pace than less serious injury. The slowest rate increase was for hip fracture (incidence rate ratio: 1.03 (95% CI 1.00, 1.06), the most common fracture type.


CONCLUSIONS
Rates of fall-related hospitalisations in older people living in aged care facilities increased at a dramatic pace in the period studied. The relative slower increase in hip fracture may point towards changing referral practices, possible success in osteoporosis management, body mass index increases in older people living in aged care facilities or a combination of these factors.
Centre for Epidemiology and Biostatistics, School of Population and Global Health, University of Melbourne, Parkville, Victoria, 3010, Australia, melissar@unimelb.edu.au.
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D000058:Accidental Falls / Q000706:statistics & numerical data*; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D050723:Fractures, Bone / Q000453:epidemiology; D006707:Homes for the Aged / Q000706:statistics & numerical data*; D006760:Hospitalization / Q000639:trends*; D006801:Humans; D008297:Male; D014739:Victoria / Q000453:epidemiology