Original Article

Osteoporosis International

, Volume 23, Issue 5, pp 1513-1519

First online:

The cost of fall related presentations to the ED: A prospective, in-person, patient-tracking analysis of health resource utilization

  • J. C. WoolcottAffiliated withFaculty of Pharmaceutical Sciences, University of British ColumbiaCollaboration for Outcomes Research and EvaluationCentre for Health Evaluation and Outcome Sciences, Providence Health Research Institute
  • , K. M. KhanAffiliated withCentre for Hip Health and Mobility, Vancouver Coastal Research InstituteDepartment of Family Practice, University of British Columbia
  • , S. MitrovicAffiliated withFaculty of Medicine, University of British Columbia
  • , A. H. AnisAffiliated withCentre for Health Evaluation and Outcome Sciences, Providence Health Research InstituteSchool of Population and Public Health, University of British Columbia
  • , C. A. MarraAffiliated withFaculty of Pharmaceutical Sciences, University of British ColumbiaCollaboration for Outcomes Research and EvaluationCentre for Health Evaluation and Outcome Sciences, Providence Health Research InstituteCentre for Health Evaluation and Outcome Sciences Email author 

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Abstract

Summary

We prospectively collected data on elderly fallers to estimate the total cost of a fall requiring an Emergency Department presentation. Using data collected on 102 falls, we found the average cost per fall causing an Emergency Department presentation of $11,408. When hospitalization was required, the average cost per fall was $29,363.

Introduction

For elderly persons, falls are a major source of mortality, morbidity, and disability. Previous Canadian cost estimates of seniors' falls were based upon administrative data that has been shown to underestimate the incidence of falls. Our objective was to use a labor-intensive, direct observation patient-tracking method to accurately estimate the total cost of falls among seniors who presented to a major urban Emergency Department (ED) in Canada.

Methods

We prospectively collected data from seniors (>70 years) presenting to the Vancouver General Hospital ED after a fall. We excluded individuals who where cognitively impaired or unable to read/write English. Data were collected on the care provided including physician assessments/consultations, radiology and laboratory tests, ED/hospital time, rehabilitation facility time, and in-hospital procedures. Unit costs of health resources were taken from a fully allocated hospital cost model.

Results

Data were collected on 101 fall-related ED presentations. The most common diagnoses were fractures (n = 33) and lacerations (n = 11). The mean cost of a fall causing ED presentation was $11,408 (SD: $19,655). Thirty-eight fallers had injuries requiring hospital admission with an average total cost of $29,363 (SD: $22,661). Hip fractures cost $39,507 (SD: $17,932). Among the 62 individuals not admitted to the hospital, the average cost of their ED visit was $674 (SD: $429).

Conclusions

Among the growing population of Canadian seniors, falls have substantial costs. With the cost of a fall-related hospitalization approaching $30,000, there is an increased need for fall prevention programs.

Keywords

Cost Economic analysis Fall Older adults