Treatment cost: The cost of treatment for older people following a fall is a significant burden on the health service, new research shows.
The annual cost of falls-related treatment for people aged over 65 in a major teaching hospital in the Republic was €10.8 million.
Doctors at Cork University Hospital (CUH) examined data for all fall-related admissions over a one-year period from May 2002 to April 2003.
There were some 810 admissions following a fall by older people during this time, with the patients needing to spend a total of 8,300 days in an acute hospital bed as a result. The average length of stay for each patient was 11 days.
Some 80 per cent of those admitted had suffered a fracture; one-half of fractures occurred at the hip joint. More women than men were admitted, while the average age of the patients was 79.
The researchers, who report their findings in the current issue of the Irish Journal of Medical Science (IJMS), found that 10 per cent of older people had to be readmitted to hospital in the year following their fall. There were significant additional costs associated with readmission, leading to the total cost for one year of fall-related admissions to an acute hospital of €10.8 million.
Commenting on the research, the lead author, Dr Paul Cotter, who is now a specialist registrar in geriatric medicine with the Galway Higher Medical Training Scheme, said: "The magnitude of the costs associated with falls came as a surprise.
"Falls are a major burden on the health service. It is an area we can do better in. There is the potential for improvements in costs and in the disastrous implications for the individual."
It cost €14,339 to treat a single hip fracture following a fall and these patients were less likely to be discharged, the study found.
"Of the survivors of hip fracture, only one-half regain mobility, despite good orthopaedic intervention and intense rehabilitation", said co-author Dr Denis O'Mahony, consultant geriatrician at CUH.
"There is a need to establish a nationwide falls prevention strategy, focusing on older people who are most at risk of an injurious fall," the authors concluded. A community-based strategy would involve interventions such as exercise programmes, balance retraining and home hazard assessment and modifications. Dr Cotter said he would especially like to see a follow-up of patients with falls who do not require emergency admission, whereby a physiotherapist and occupational therapist would call to the person's home to help to prevent further falls.
An accompanying editorial in the IJMS criticised the lack of spending on falls prevention in older people.
"The steadily increasing annual General Medical Services spending on drugs (to prevent osteoporosis) is not matched by a simultaneous increase in resources towards multidisciplinary assessment and interventions, despite the accumulating evidence for robust cost effectiveness of the latter," it said.