title: Savings in acute care costs if all older adults treated for fall-related injuries completed matter of balance.
abstract: BACKGROUND
  Falls among older adults are a common and serious public health problem. Evidence-based fall prevention programs delivered in community settings and targeting older adults living independently are increasingly deployed throughout the nation. These programs tend to be offered by public and private organizations that serve older adults, and recruitment usually occurs through direct marketing to the target population, rather than through referrals from healthcare providers.Matter of Balance, a program developed to reduce fear of falling and associated activity restriction in community-dwelling older adults, is currently being delivered in 38 of the 50 United States. In this study, we estimate the one-year medical care cost savings if older adults treated at Massachusetts hospitals for fall-related injuries were referred by healthcare providers to participate inMatter of Balance.
  
  
  METHODS
  Data from several sources were used for this study. We estimated annual cost savings in older adult falls recidivism for a hypothetical 100 patients presenting at an emergency department for a fall-related injury, assuming that all were referred to, and 50 % completed,Matter of Balance. This cost-saving estimate was subsequently expanded based on the actual number (43,931) of older adult patients presenting at, and discharged from Massachusetts emergency departments for all fall-related injuries in 2012. Cost savings were calculated for two additional participation rates: 25 % and 75 %. The return on investment (ROI), was calculated based on the percentage of return per each dollar invested.
  
  
  RESULTS
  The calculated ROI forMatter of Balancewas 144 %. Statewide savings ranged from $2.79 million assuming a 25 % participation rate to $8.37 million, assuming a 75 % participation rate.
  
  
  CONCLUSIONS
  Referral to evidence-based falls prevention programs of older adult patients presenting at EDs with a fall-related injury could reduce subsequent falls and associated treatment costs.
authors.affiliation: Department of Emergency Medicine, Boston University Medical Center and Boston University School of Medicine, One Boston Medical Center Place, Dowling 1 South, Boston, MA 02118 USA ; Boston Medical Center Injury Prevention Center, Boston, MA 02118 USA.
authors.forename: Jonathan
authors.initials: J
authors.lastname: Howland
authors.affiliation: Department of Emergency Medicine, Boston University Medical Center and Boston University School of Medicine, One Boston Medical Center Place, Dowling 1 South, Boston, MA 02118 USA ; Boston Medical Center Injury Prevention Center, Boston, MA 02118 USA.
authors.forename: Kalpana Narayan
authors.initials: KN
authors.lastname: Shankar
authors.affiliation: Department of Occupational Therapy, University of Illinois at Chicago, Boston, MA 02118 USA.
authors.forename: Elizabeth W
authors.initials: EW
authors.lastname: Peterson
authors.affiliation: Department of Emergency Medicine, Boston University Medical Center and Boston University School of Medicine, One Boston Medical Center Place, Dowling 1 South, Boston, MA 02118 USA ; Boston Medical Center Injury Prevention Center, Boston, MA 02118 USA.
authors.forename: Alyssa A
authors.initials: AA
authors.lastname: Taylor
keywords: Community-based; Cost-effectiveness; Emergency departments; Falls; Interventions; Massachusetts; Matter of Balance; Older adults