The costs of fatal and non-fatal falls among older adults
The costs of fatal and non-fatal falls among older adults
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DOI：
10.1136/ip.2005.011015
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发表时间：
2006-10-01
影响因子：
3.7
通讯作者：
Miller, T. R.
中科院分区：
文献类型：
--
作者：
Stevens, J. A.;Corso, P. S.;Miller, T. R.
目的：以年龄、性别、身体部位和损伤类型为分层标准，估算2000年美国65岁成人致命性和非致命性坠落伤的发病率和直接医疗费用。方法：发病率数据来自2000年国家生命统计系统、2001年国家电子伤害监测系统-所有伤害计划、2000年医疗保健利用计划全国住院患者样本和1999年医疗费用小组调查。致命跌倒的成本来自美国的伤害发生率和经济负担；非致命跌倒的成本基于1998年和1999年医疗保险服务费用5%标准分析文件中的索赔。结果：2000年有近10300例致命性伤害和260万例非致死性跌倒相关伤害得到治疗。致命伤害的直接医疗费用总计2亿美元，非致命伤害的直接医疗费用为190亿美元。在非致命伤害费用中，63%(120亿美元)用于住院治疗，21%(40亿美元)用于急诊科就诊，16%(30亿美元)用于门诊治疗。在所有医疗环境中，占老年人口58%的女性的医疗支出是男性的2-3倍。骨折只占非致命性伤害的35%，但占成本的61%。结论：老年人，特别是老年女性，与跌倒相关的伤害与巨大的经济成本有关。实施有效的干预策略可以显著降低这些伤害的发生率和医疗费用。
Objective: To estimate the incidence and direct medical costs for fatal and non-fatal fall injuries among US adults aged >= 65 years in 2000, for three treatment settings stratified by age, sex, body region, and type of injury.Methods: Incidence data came from the 2000 National Vital Statistics System, 2001 National Electronic Injury Surveillance System-All Injury Program, 2000 Health Care Utilization Program National Inpatient Sample, and 1999 Medical Expenditure Panel Survey. Costs for fatal falls came from Incidence and economic burden of injuries in the United States; costs for non-fatal falls were based on claims from the 1998 and 1999 Medicare fee-for-service 5% Standard Analytical Files. A case crossover approach was used to compare the monthly costs before and after the fall.Results: In 2000, there were almost 10 300 fatal and 2.6 million medically treated non-fatal fall related injuries. Direct medical costs totaled $0.2 billion dollars for fatal and $19 billion dollars for non-fatal injuries. Of the non-fatal injury costs, 63% ($12 billion) were for hospitalizations, 21% ($4 billion) were for emergency department visits, and 16% ($3 billion) were for treatment in outpatient settings. Medical expenditures for women, who comprised 58% of the older adult population, were 2-3 times higher than for men for all medical treatment settings. Fractures accounted for just 35% of non-fatal injuries but 61% of costs.Conclusions: Fall related injuries among older adults, especially among older women, are associated with substantial economic costs. Implementing effective intervention strategies could appreciably decrease the incidence and healthcare costs of these injuries.