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The Financial Cost of Falls among Older Adults

In 2000, falls among older adults cost the U.S. health care system over $19 billion dollars. With the population aging, both the number of falls and the costs to treat fall injuries are likely to increase.

How big is the problem?

  • One in three adults age 65 and older falls each year.
  • Of those who fall, 20% to 30% suffer moderate to severe injuries that make it hard for them to get around or live independently, and increase their risk of early death.
  • Older adults are hospitalized for fall-related injuries five times more often than they are for injuries from other causes.
  • In 2009, emergency departments treated 2.2 million nonfatal fall injuries among older adults; more than 582,000 of these patients had to be hospitalized.

How are costs calculated?

The costs of fall-related injuries are often shown in terms of direct costs.

  • Direct costs are what patients and insurance companies pay for treating fall-related injuries. These costs include fees for hospital and nursing home care, doctors and other professional services, rehabilitation, community-based services, use of medical equipment, prescription drugs, changes made to the home, and insurance processing.
  • Direct costs do not account for the long-term effects of these injuries such as disability, dependence on others, lost time from work and household duties, and reduced quality of life.

How costly are fall-related injuries among older adults?

  • In 2000, the total direct medical costs of all fall injuries for people 65 and older exceeded $19 billion: $0.2 billion for fatal falls, and $19 billion for nonfatal falls. 
  • By 2020, the annual direct and indirect cost of fall injuries is expected to reach $54.9 billion (in 2007 dollars).
  • Among community-dwelling older adults, fall-related injury is one of the 20 most expensive medical conditions.
  • In 2002, about 22% of community-dwelling seniors reported falling in the previous year.  Medicare costs per fall averaged between $9,113 and $13,507.
  • Among community-dwelling seniors treated for fall injuries, 65% of direct medical costs were for inpatient hospitalizations; 10% each for medical office visits and home health care, 8% for hospital outpatient visits, 7% for emergency room visits, and 1% each for prescription drugs and dental visits. About 78% of these costs were reimbursed by Medicare.
  • In a study of people age 72 and older, the average health care cost of a fall injury totaled $19,440, which included hospital, nursing home, emergency room, and home health care, but not doctors’ services.

How do these costs break down?

Age and sex

  • The costs of fall injuries increase rapidly with age.
  • In 2000, the costs of both fatal and nonfatal falls were higher for women than for men.
  • Medical costs in 2000 for women, who comprised 58% of older adults, were two to three times higher than for men.

Type of injury and treatment setting

  • In 2000, traumatic brain injuries (TBI) and injuries to the hips, legs, and feet were the most common and costly fatal fall injuries, and accounted for 78% of fatalities and 79% of costs.  
  • Injuries to internal organs caused 28% of deaths and accounted for 29% of costs from fatal falls. 
  • Fractures were both the most common and most costly type of nonfatal injuries. Just over one third of nonfatal injuries were fractures, but they accounted for 61% of costs—or $12 billion.
  • Hospitalizations accounted for nearly two thirds of the costs of nonfatal fall injuries, and emergency department treatment accounted for 20%. 
  • On average, the hospitalization cost for a fall injury is $17,500.
  • Hip fractures are the most frequent type of fall-related fractures. The cost of hospitalization for hip fracture averaged about $18,000.  Hospitalization costs accounted for 44% of direct medical costs for hip fractures.

Content source: Centers for Disease Control and Prevention, National Center for Injury Prevention and Control, Division of Unintentional Injury Prevention