Skip to main content
Erschienen in: Osteoporosis International 8/2010

01.08.2010 | Review

International comparison of cost of falls in older adults living in the community: a systematic review

verfasst von: J. C. Davis, M. C. Robertson, M. C. Ashe, T. Liu-Ambrose, K. M. Khan, C. A. Marra

Erschienen in: Osteoporosis International | Ausgabe 8/2010

Einloggen, um Zugang zu erhalten

Abstract

Summary

Our objective was to determine international estimates of the economic burden of falls in older people living in the community. Our systematic review emphasized the need for a consensus on methodology for cost of falls studies to enable more accurate comparisons and subgroup-specific estimates among different countries.

Introduction

The purpose of this study was to determine international estimates of the economic burden of falls in older people living in the community.

Methods

This is a systematic review of peer-reviewed journal articles reporting estimates for the cost of falls in people aged ≥60 years living in the community. We searched for papers published between 1945 and December 2008 in MEDLINE, PUBMED, EMBASE, CINAHL, Cochrane Collaboration, and NHS EED databases that identified cost of falls in older adults. We extracted the cost of falls in the reported currency and converted them to US dollars at 2008 prices, cost items measured, perspective, time horizon, and sensitivity analysis. We assessed the quality of the studies using a selection of questions from Drummond’s checklist.

Results

Seventeen studies met our inclusion criteria. Studies varied with respect to viewpoint of the analysis, definition of falls, identification of important and relevant cost items, and time horizon. Only two studies reported a sensitivity analysis and only four studies identified the viewpoint of their economic analysis. In the USA, non-fatal and fatal falls cost US $23.3 billion (2008 prices) annually and US $1.6 billion in the UK.

Conclusions

The economic cost of falls is likely greater than policy makers appreciate. The mean cost of falls was dependent on the denominator used and ranged from US $3,476 per faller to US $10,749 per injurious fall and US $26,483 per fall requiring hospitalization. A consensus on methodology for cost of falls studies would enable more accurate comparisons and subgroup-specific estimates among different countries.
Literatur
1.
Zurück zum Zitat Tinetti ME, Williams CS (1997) Falls, injuries due to falls, and the risk of admission to a nursing home. N Engl J Med 337:1279–1284CrossRefPubMed Tinetti ME, Williams CS (1997) Falls, injuries due to falls, and the risk of admission to a nursing home. N Engl J Med 337:1279–1284CrossRefPubMed
2.
Zurück zum Zitat Campbell AJ, Borrie MJ, Spears GF (1989) Risk factors for falls in a community-based prospective study of people 70 years and older. J Gerontol 44:M112–M117PubMed Campbell AJ, Borrie MJ, Spears GF (1989) Risk factors for falls in a community-based prospective study of people 70 years and older. J Gerontol 44:M112–M117PubMed
3.
Zurück zum Zitat Tinetti ME, Speechley M, Ginter SF (1988) Risk factors for falls among elderly persons living in the community. N Engl J Med 319:1701–1707PubMed Tinetti ME, Speechley M, Ginter SF (1988) Risk factors for falls among elderly persons living in the community. N Engl J Med 319:1701–1707PubMed
4.
Zurück zum Zitat National Center for Injury Prevention and Control (1998) National Center for Injury Prevention and Control: statistics and activities. Int J Trauma Nurs 4:18–22 National Center for Injury Prevention and Control (1998) National Center for Injury Prevention and Control: statistics and activities. Int J Trauma Nurs 4:18–22
5.
Zurück zum Zitat Sattin RW, Lambert Huber DA, DeVito CA, Rodriguez JG, Ros A, Bacchelli S, Stevens JA, Waxweiler RJ (1990) The incidence of fall injury events among the elderly in a defined population. Am J Epidemiol 131:1028–1037PubMed Sattin RW, Lambert Huber DA, DeVito CA, Rodriguez JG, Ros A, Bacchelli S, Stevens JA, Waxweiler RJ (1990) The incidence of fall injury events among the elderly in a defined population. Am J Epidemiol 131:1028–1037PubMed
6.
Zurück zum Zitat Davis JC, Robertson MC, Ashe MC, Liu-Ambrose T, Khan KM, Marra CA (2009) Does a home-based strength and balance programme in people aged ≥80 years provide the best value for money to prevent falls? A systematic review of economic analyses of falls prevention interventions. Br J Sports Med. 6 Aug 2009 (Epub ahead of print). doi:10.1136/bjsm.2009.060988 Davis JC, Robertson MC, Ashe MC, Liu-Ambrose T, Khan KM, Marra CA (2009) Does a home-based strength and balance programme in people aged ≥80 years provide the best value for money to prevent falls? A systematic review of economic analyses of falls prevention interventions. Br J Sports Med. 6 Aug 2009 (Epub ahead of print). doi:10.​1136/​bjsm.​2009.​060988
7.
Zurück zum Zitat Moher D, Cook DJ, Eastwood S, Olkin I, Rennie D, Stroup DF (1999) Improving the quality of reports of meta-analyses of randomised controlled trials: the QUOROM statement. Quality of reporting of meta-analyses. Lancet 354:1896–1900CrossRefPubMed Moher D, Cook DJ, Eastwood S, Olkin I, Rennie D, Stroup DF (1999) Improving the quality of reports of meta-analyses of randomised controlled trials: the QUOROM statement. Quality of reporting of meta-analyses. Lancet 354:1896–1900CrossRefPubMed
8.
Zurück zum Zitat Drummond MF, Sculpher MJ, Torrance GW, O'Brien B, Stoddart GL (2005) Methods for the economic evaluation of health care programmes, 3rd edn. Oxford University Press, New York Drummond MF, Sculpher MJ, Torrance GW, O'Brien B, Stoddart GL (2005) Methods for the economic evaluation of health care programmes, 3rd edn. Oxford University Press, New York
10.
Zurück zum Zitat Welte R, Feenstra T, Jager H, Leidl R (2004) A decision chart for assessing and improving the transferability of economic evaluation results between countries. Pharmacoeconomics 22:857–876CrossRefPubMed Welte R, Feenstra T, Jager H, Leidl R (2004) A decision chart for assessing and improving the transferability of economic evaluation results between countries. Pharmacoeconomics 22:857–876CrossRefPubMed
11.
Zurück zum Zitat Englander F, Hodson TJ, Terregrossa RA (1996) Economic dimensions of slip and fall injuries. J Forensic Sci 41:733–746PubMed Englander F, Hodson TJ, Terregrossa RA (1996) Economic dimensions of slip and fall injuries. J Forensic Sci 41:733–746PubMed
12.
Zurück zum Zitat Carroll NV, Slattum PW, Cox FM (2005) The cost of falls among the community-dwelling elderly. J Manag Care Pharm 11:307–316PubMed Carroll NV, Slattum PW, Cox FM (2005) The cost of falls among the community-dwelling elderly. J Manag Care Pharm 11:307–316PubMed
13.
Zurück zum Zitat Rizzo JA, Friedkin R, Williams CS, Nabors J, Acampora D, Tinetti ME (1998) Health care utilization and costs in a Medicare population by fall status. Med Care 36:1174–1188CrossRefPubMed Rizzo JA, Friedkin R, Williams CS, Nabors J, Acampora D, Tinetti ME (1998) Health care utilization and costs in a Medicare population by fall status. Med Care 36:1174–1188CrossRefPubMed
14.
Zurück zum Zitat Stevens JA, Corso PS, Finkelstein EA, Miller TR (2006) The costs of fatal and non-fatal falls among older adults. Inj Prev 12:290–295CrossRefPubMed Stevens JA, Corso PS, Finkelstein EA, Miller TR (2006) The costs of fatal and non-fatal falls among older adults. Inj Prev 12:290–295CrossRefPubMed
15.
Zurück zum Zitat Finkelstein EA, Chen H, Miller TR, Corso PS, Stevens JA (2005) A comparison of the case–control and case–crossover designs for estimating medical costs of nonfatal fall related injuries among older Americans. Med Care 43:1087–1091CrossRefPubMed Finkelstein EA, Chen H, Miller TR, Corso PS, Stevens JA (2005) A comparison of the case–control and case–crossover designs for estimating medical costs of nonfatal fall related injuries among older Americans. Med Care 43:1087–1091CrossRefPubMed
16.
Zurück zum Zitat Alexander BH, Rivara FP, Wolf ME (1992) The cost and frequency of hospitalization for fall related injuries in older adults. Am J Public Health 82:1020–1023CrossRefPubMed Alexander BH, Rivara FP, Wolf ME (1992) The cost and frequency of hospitalization for fall related injuries in older adults. Am J Public Health 82:1020–1023CrossRefPubMed
17.
Zurück zum Zitat Roudsari BS, Ebel BE, Corso PS, Molinari NA, Koepsell TD (2005) The acute medical care costs of fall related injuries among the U.S. older adults. Injury 36:1316–1322CrossRefPubMed Roudsari BS, Ebel BE, Corso PS, Molinari NA, Koepsell TD (2005) The acute medical care costs of fall related injuries among the U.S. older adults. Injury 36:1316–1322CrossRefPubMed
18.
Zurück zum Zitat Ellis AA, Trent RB (2001) Do the risks and consequences of hospitalized fall injuries among older adults in California vary by type of fall? J Gerontol A Biol Sci Med Sci 56:M686–M692PubMed Ellis AA, Trent RB (2001) Do the risks and consequences of hospitalized fall injuries among older adults in California vary by type of fall? J Gerontol A Biol Sci Med Sci 56:M686–M692PubMed
19.
Zurück zum Zitat Mahoney JE, Glysch RL, Guilfoyle SM, Hale LJ, Katcher ML (2005) Trends, risk factors, and prevention of falls in older adults in Wisconsin. WMJ 104:22–28PubMed Mahoney JE, Glysch RL, Guilfoyle SM, Hale LJ, Katcher ML (2005) Trends, risk factors, and prevention of falls in older adults in Wisconsin. WMJ 104:22–28PubMed
20.
Zurück zum Zitat Newton JL, Kyle P, Liversidge P, Robinson G, Wilton K, Reeve P (2006) The costs of falls in the community to the North East Ambulance Service. Emerg Med J 23:479–481CrossRefPubMed Newton JL, Kyle P, Liversidge P, Robinson G, Wilton K, Reeve P (2006) The costs of falls in the community to the North East Ambulance Service. Emerg Med J 23:479–481CrossRefPubMed
21.
Zurück zum Zitat Scuffham P, Chaplin S, Legood R (2003) Incidence and costs of unintentional falls in older people in the United Kingdom. J Epidemiol Community Health 57:740–744CrossRefPubMed Scuffham P, Chaplin S, Legood R (2003) Incidence and costs of unintentional falls in older people in the United Kingdom. J Epidemiol Community Health 57:740–744CrossRefPubMed
22.
Zurück zum Zitat Hall SE, Hendrie DV (2003) A prospective study of the costs of falls in older adults living in the community. Aust N Z J Public Health 27:343–351CrossRefPubMed Hall SE, Hendrie DV (2003) A prospective study of the costs of falls in older adults living in the community. Aust N Z J Public Health 27:343–351CrossRefPubMed
23.
Zurück zum Zitat Hendrie D, Hall SE, Arena G, Legge M (2004) Health system costs of falls of older adults in Western Australia. Aust Health Rev 28:363–373CrossRefPubMed Hendrie D, Hall SE, Arena G, Legge M (2004) Health system costs of falls of older adults in Western Australia. Aust Health Rev 28:363–373CrossRefPubMed
24.
Zurück zum Zitat Seematter-Bagnoud L, Wietlisbach V, Yersin B, Bula CJ (2006) Healthcare utilization of elderly persons hospitalized after a noninjurious fall in a Swiss academic medical center. J Am Geriatr Soc 54:891–897CrossRefPubMed Seematter-Bagnoud L, Wietlisbach V, Yersin B, Bula CJ (2006) Healthcare utilization of elderly persons hospitalized after a noninjurious fall in a Swiss academic medical center. J Am Geriatr Soc 54:891–897CrossRefPubMed
25.
Zurück zum Zitat Cotter PE, Timmons S, O’Connor M, Twomey C, O'Mahony D (2006) The financial implications of falls in older people for an acute hospital. Ir J Med Sci 175:11–13CrossRefPubMed Cotter PE, Timmons S, O’Connor M, Twomey C, O'Mahony D (2006) The financial implications of falls in older people for an acute hospital. Ir J Med Sci 175:11–13CrossRefPubMed
26.
Zurück zum Zitat Panneman MJ, Goettsch WG, Kramarz P, Herings RM (2003) The costs of benzodiazepine-associated hospital-treated fall injuries in the EU: a Pharmo Study. Drugs Aging 20:833–839CrossRefPubMed Panneman MJ, Goettsch WG, Kramarz P, Herings RM (2003) The costs of benzodiazepine-associated hospital-treated fall injuries in the EU: a Pharmo Study. Drugs Aging 20:833–839CrossRefPubMed
27.
Zurück zum Zitat Sjogren H, Bjornstig U (1991) Trauma in the elderly: the impact on the health care system. Scand J Prim Health Care 9:203–207CrossRefPubMed Sjogren H, Bjornstig U (1991) Trauma in the elderly: the impact on the health care system. Scand J Prim Health Care 9:203–207CrossRefPubMed
28.
Zurück zum Zitat Bansback N, Ara R, Ward S, Anis A, Choi HK (2009) Statin therapy in rheumatoid arthritis: a cost-effectiveness and value-of-information analysis. Pharmacoeconomics 27:25–37CrossRefPubMed Bansback N, Ara R, Ward S, Anis A, Choi HK (2009) Statin therapy in rheumatoid arthritis: a cost-effectiveness and value-of-information analysis. Pharmacoeconomics 27:25–37CrossRefPubMed
29.
Zurück zum Zitat Mycek S (2004) The dire cost of obesity. Mater Manag Health Care 13:18–21PubMed Mycek S (2004) The dire cost of obesity. Mater Manag Health Care 13:18–21PubMed
30.
Zurück zum Zitat Drummond MF, Barbieri M, Cook J, Glick HA, Lis J, Malik F, Reed S, Rutten F, Sculpher M, Severens J (2009) Transferability of economic evaluations across jurisdictions: ISPOR Good Research Practices Task Force Report. Value Health 12:409–418CrossRefPubMed Drummond MF, Barbieri M, Cook J, Glick HA, Lis J, Malik F, Reed S, Rutten F, Sculpher M, Severens J (2009) Transferability of economic evaluations across jurisdictions: ISPOR Good Research Practices Task Force Report. Value Health 12:409–418CrossRefPubMed
31.
Zurück zum Zitat Yabroff KR, Warren JL, Banthin J, Schrag D, Mariotto A, Lawrence W, Meekins A, Topor M, Brown ML (2009) Comparison of approaches for estimating prevalence costs of care for cancer patients: what is the impact of data source? Med Care 47:S64–S69CrossRefPubMed Yabroff KR, Warren JL, Banthin J, Schrag D, Mariotto A, Lawrence W, Meekins A, Topor M, Brown ML (2009) Comparison of approaches for estimating prevalence costs of care for cancer patients: what is the impact of data source? Med Care 47:S64–S69CrossRefPubMed
32.
Zurück zum Zitat Yabroff KR, Warren JL, Schrag D, Mariotto A, Meekins A, Topor M, Brown ML (2009) Comparison of approaches for estimating incidence costs of care for colorectal cancer patients. Med Care 47:S56–S63CrossRefPubMed Yabroff KR, Warren JL, Schrag D, Mariotto A, Meekins A, Topor M, Brown ML (2009) Comparison of approaches for estimating incidence costs of care for colorectal cancer patients. Med Care 47:S56–S63CrossRefPubMed
33.
Zurück zum Zitat Koopmanschap MA (1998) Cost-of-illness studies. Useful for health policy? Pharmacoeconomics 14:143–148CrossRefPubMed Koopmanschap MA (1998) Cost-of-illness studies. Useful for health policy? Pharmacoeconomics 14:143–148CrossRefPubMed
34.
Zurück zum Zitat Hodgson TA, Meiners MR (1982) Cost-of-illness methodology: a guide to current practices and procedures. Milbank Mem Fund Q Health Soc 60:429–462CrossRefPubMed Hodgson TA, Meiners MR (1982) Cost-of-illness methodology: a guide to current practices and procedures. Milbank Mem Fund Q Health Soc 60:429–462CrossRefPubMed
35.
Zurück zum Zitat Gillespie LD, Robertson MC, Gillespie WJ, Lamb SE, Gates S, Cumming RG, Rowe BH (2009) Interventions for preventing falls in older people living in the community. Cochrane Database of Systematic Reviews Issue 2. Art.No.:CD007146. doi:10.1002/14651858.CD007146.pub2 Gillespie LD, Robertson MC, Gillespie WJ, Lamb SE, Gates S, Cumming RG, Rowe BH (2009) Interventions for preventing falls in older people living in the community. Cochrane Database of Systematic Reviews Issue 2. Art.No.:CD007146. doi:10.​1002/​14651858.​CD007146.​pub2
Metadaten
Titel
International comparison of cost of falls in older adults living in the community: a systematic review
verfasst von
J. C. Davis
M. C. Robertson
M. C. Ashe
T. Liu-Ambrose
K. M. Khan
C. A. Marra
Publikationsdatum
01.08.2010
Verlag
Springer-Verlag
Erschienen in
Osteoporosis International / Ausgabe 8/2010
Print ISSN: 0937-941X
Elektronische ISSN: 1433-2965
DOI
https://doi.org/10.1007/s00198-009-1162-0

Weitere Artikel der Ausgabe 8/2010

Osteoporosis International 8/2010 Zur Ausgabe

Arthropedia

Grundlagenwissen der Arthroskopie und Gelenkchirurgie. Erweitert durch Fallbeispiele, Videos und Abbildungen. 
» Jetzt entdecken

TEP mit Roboterhilfe führt nicht zu größerer Zufriedenheit

15.05.2024 Knie-TEP Nachrichten

Der Einsatz von Operationsrobotern für den Einbau von Totalendoprothesen des Kniegelenks hat die Präzision der Eingriffe erhöht. Für die postoperative Zufriedenheit der Patienten scheint das aber unerheblich zu sein, wie eine Studie zeigt.

Lever-Sign-Test hilft beim Verdacht auf Kreuzbandriss

15.05.2024 Vordere Kreuzbandruptur Nachrichten

Mit dem Hebelzeichen-Test lässt sich offenbar recht zuverlässig feststellen, ob ein vorderes Kreuzband gerissen ist. In einer Metaanalyse war die Vorhersagekraft vor allem bei positivem Testergebnis hoch.

Ein Drittel der jungen Ärztinnen und Ärzte erwägt abzuwandern

07.05.2024 Klinik aktuell Nachrichten

Extreme Arbeitsverdichtung und kaum Supervision: Dr. Andrea Martini, Sprecherin des Bündnisses Junge Ärztinnen und Ärzte (BJÄ) über den Frust des ärztlichen Nachwuchses und die Vorteile des Rucksack-Modells.

Aquatherapie bei Fibromyalgie wirksamer als Trockenübungen

03.05.2024 Fibromyalgiesyndrom Nachrichten

Bewegungs-, Dehnungs- und Entspannungsübungen im Wasser lindern die Beschwerden von Patientinnen mit Fibromyalgie besser als das Üben auf trockenem Land. Das geht aus einer spanisch-brasilianischen Vergleichsstudie hervor.

Update Orthopädie und Unfallchirurgie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.