Unintentional falls Hospital Discharge ages 65 and older

• CDC reports the death rate from falls among older adults has increased by 42 percent from 2000 to 2006. Each year, one in three Americans aged 65 and over falls. In 2010, over 2.3 million nonfatal fall injuries among older adults were treated in emergency departments with more than 650,000 of these hospitalized.

• In 2012, over $30 billion in direct medical costs was spent treating older adults for the effects of falls, with 78% of these costs reimbursed by Medicare. Medicare costs in the first year after a fall averaged between $13,797 and $20,450. If we cannot stem the rate of increase in falls, it is projected that the cost in 2020 would be $67.7 billion, including Medicare costs estimated at about $48 billion.

• One of the greatest financial challenges facing our nation is the rising cost of health care services. Reducing falls among older Americans will significantly decrease these health costs, save lives and improve quality of life.

Source: CDC

Leading Hospital Discharge by DRG ages 65 and older with unintentional falls, risk associated with

Hospitalizations for falls in Bexar County 2014APR_DRG Description Frequency

308 Hip & femur procedures for trauma except joint replacement 692301 Hip joint replacement 410

55 Head trauma w coma >1 hr or hemorrhage 208342 Fracture & dislocation except femur, pelvis & back 197313 Knee & lower leg procedures except foot 163315 Shoulder, upper arm & forearm procedures 146347 Other back & neck disorders, fractures & injuries 143340 Fractures of femur 121341 Fracture of pelvis or dislocation of hip 106463 Kidney & urinary tract infections 102720 Septicemia & disseminated infections 95860 Rehabilitation 93310 Intervertebral disc excision & decompression 83204 Syncope & collapse 81351 Other musculoskeletal system & connective tissue diagnoses 78384 Contusion, open wound & other trauma to skin & subcutaneous tissue 76460 Renal failure 68135 Major chest & respiratory trauma 67

45 Cva & precerebral occlusion w infarct 61139 Other pneumonia 59

SOURCE: Hospital Discharge Texas Hospital Inpatient Discharge Public Use Data File.

Unintentional falls Hospital Discharge ages 65 and older for Select Texas Counties 2014

SOURCE: Hospital Discharge Texas Hospital Inpatient Discharge Public Use Data File.

County2014 Total Population Falls

rate per 1,000

Atascosa 47,812 136 2.8Bandera 20,916 72 3.4Bexar 1,860,274 4,298 2.3Comal 123,439 333 2.7Frio 18,577 51 2.7Guadalupe 147,272 233 1.6Kendall 38,761 155 4.0Medina 47,876 85 1.8Wilson 46,440 87 1.9

Discharges were selected for unintentional fall ICD9 E code E880 to E888 among the 10 diagnostic fields

Accidental Falls E880-E888 >E880 Accidental fall on or from stairs or stepsE881 Accidental fall on or from ladders or scaffoldingE882 Accidental fall from or out of building or other structureE883 Accidental fall into hole or other opening in surfaceE884 Other accidental falls from one level to anotherE885 Accidental fall on same level from slipping tripping or stumblingE886 Fall on same level from collision, pushing, or shoving, by or with other personE887 Fracture, cause unspecifiedE888 Other and unspecified fall

SOURCE: Hospital Discharge Texas Hospital Inpatient Discharge Public Use Data File.

I used the method in the attached paper as a guide. https://www.wisconsinmedicalsociety.org/_WMS/publications/wmj/pdf/102/4/37.pdfBexar County had a total of 4,298 hospital admissions of falls ages 65 and older and Texas 60,781.