title: The Costs of Fall-Related Injuries among Older Adults: Annual Per-Faller, Service Component, and Patient Out-of-Pocket Costs.
abstract: To estimate expenditures for fall-related injuries (FRIs) among older Medicare beneficiaries.
  
  
  
  The 2007-2009 Medicare claims and 2008 Health and Retirement Study (HRS) data for 5,497 (228 FRI and 5,269 non-FRI) beneficiaries.
  
  
  
  FRIs were indicated by inpatient/outpatient ICD-9 diagnostic codes for fractures, trauma, dislocations, and by e-codes. A pre-post comparison group design was used to estimate the differential change in pre-post expenditures for the FRI relative to the non-FRI cohort (FRI expenditures). Out-of-pocket (OOP) costs, service category total annual FRI-related Medicare expenditures, expenditures related to the type of initial FRI treatment (inpatient, ED, outpatient), and the risk of persistently high expenditures (4th quartile for each post-FRI quarter) were estimated.
  
  
  
  Estimated FRI expenditures were $9,389 (95 percent CI: $5,969-$12,808). Inpatient, physician/outpatient, skilled nursing facility, and home health comprised 31, 18, 39, and 12 percent of the total. OOP costs were $1,363.0 (95 percent CI: $889-$1,837). Expenditures for FRIs initially treated in inpatient/ED/outpatient settings were $21,424/$6,142/$8,622. The FRI cohort had a 64 percent increased risk of persistently high expenditures. Total Medicare expenditures were $13 billion (95 percent CI: $9-$18 billion).
  
  
  
  FRIs are associated with substantial, persistent Medicare expenditures. Cost-effectiveness of multifactorial falls prevention programs should be assessed using these expenditure estimates.
authors: Department of Systems, Populations and Leadership, University of Michigan School of Nursing, Ann Arbor, MI.
authors: Geoffrey J
authors: GJ
authors: Hoffman
authors: Division of General Internal Medicine and Health Services Research, David Geffen School of Medicine, UCLA, Los Angeles, CA.|Department of Health Policy and Management, UCLA Fielding School of Public Health, Los Angeles, CA.
authors: Ron D
authors: RD
authors: Hays
authors: Division of General Internal Medicine and Health Services Research, David Geffen School of Medicine, UCLA, Los Angeles, CA.|Department of Health Policy and Management, UCLA Fielding School of Public Health, Los Angeles, CA.
authors: Martin F
authors: MF
authors: Shapiro
authors: Department of Community Health Sciences, UCLA Fielding School of Public Health, Los Angeles, CA.
authors: Steven P
authors: SP
authors: Wallace
authors: Division of General Internal Medicine and Health Services Research, David Geffen School of Medicine, UCLA, Los Angeles, CA.
authors: Susan L
authors: SL
authors: Ettner
mesh_terms: D000058:Accidental Falls / Q000191:economics*; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005382:Financing, Personal / Q000191:economics*; D005102:Health Expenditures / Q000706:statistics & numerical data*; D006296:Health Services / Q000191:economics / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D006278:Medicare / Q000191:economics*; D017059:Models, Econometric; D012737:Sex Factors; D012959:Socioeconomic Factors; D014481:United States; D014947:Wounds and Injuries / Q000191:economics*
keywords: Medicare; direct medical expenditures; elderly; fall-related injuries; falls