Healthcare spending for non-fatal falls among older adults, USA.

IF 2.5 3区 医学 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Injury Prevention Pub Date : 2024-07-19 DOI:10.1136/ip-2023-045023
Yara K Haddad, Gabrielle F Miller, Ramakrishna Kakara, Curtis Florence, Gwen Bergen, Elizabeth Rose Burns, Adam Atherly
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Abstract

Background: The older adult (65+) population in the USA is increasing and with it the number of medically treated falls. In 2015, healthcare spending attributable to older adult falls was approximately US$50 billion. We aim to update the estimated medical expenditures attributable to older adult non-fatal falls.

Methods: Generalised linear models using 2017, 2019 and 2021 Medicare Current Beneficiary Survey and cost supplement files were used to estimate the association of falls with healthcare expenditures while adjusting for demographic characteristics and health conditions in the model. To portion out the share of total healthcare spending attributable to falls versus not, we adjusted for demographic characteristics and health conditions, including self-reported health status and certain comorbidities associated with increased risk of falling or higher healthcare expenditure. We calculated a fall-attributable fraction of expenditure as total expenditures minus total expenditures with no falls divided by total expenditures. We applied the fall-attributable fraction of expenditure from the regression model to the 2020 total expenditures from the National Health Expenditure Data to calculate total healthcare spending attributable to older adult falls.

Results: In 2020, healthcare expenditure for non-fatal falls was US$80.0 billion, with the majority paid by Medicare.

Conclusion: Healthcare spending for non-fatal older adult falls was substantially higher than previously reported estimates. This highlights the growing economic burden attributable to older adult falls and these findings can be used to inform policies on fall prevention efforts in the USA.

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美国老年人非致命性跌倒的医疗支出。
背景:美国的老年人(65 岁以上)人口在不断增加,随之而来的是接受医疗治疗的跌倒人数也在增加。2015 年,老年人跌倒导致的医疗支出约为 500 亿美元。我们旨在更新可归因于老年人非致命性跌倒的医疗支出估算:方法:使用 2017 年、2019 年和 2021 年医疗保险当前受益人调查和成本补充文件的广义线性模型来估算跌倒与医疗支出的关系,同时在模型中对人口特征和健康状况进行调整。为了划分出跌倒与非跌倒在医疗支出总额中所占的比例,我们对人口特征和健康状况进行了调整,包括自我报告的健康状况以及与跌倒风险增加或医疗支出增加相关的某些合并症。我们计算了可归因于跌倒的支出比例,即总支出减去未发生跌倒的总支出,再除以总支出。我们将回归模型得出的可归因于跌倒的支出比例应用于国民健康支出数据中的 2020 年总支出,从而计算出老年人跌倒可归因于的医疗支出总额:2020年,非致命性跌倒的医疗支出为800亿美元,其中大部分由医疗保险支付:结论:老年人非致命性跌倒的医疗支出大大高于之前报告的估计值。这凸显了老年人跌倒造成的经济负担日益加重,这些发现可为美国预防跌倒的政策提供参考。
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来源期刊
Injury Prevention
Injury Prevention 医学-公共卫生、环境卫生与职业卫生
CiteScore
5.30
自引率
2.70%
发文量
68
审稿时长
6-12 weeks
期刊介绍: Since its inception in 1995, Injury Prevention has been the pre-eminent repository of original research and compelling commentary relevant to this increasingly important field. An international peer reviewed journal, it offers the best in science, policy, and public health practice to reduce the burden of injury in all age groups around the world. The journal publishes original research, opinion, debate and special features on the prevention of unintentional, occupational and intentional (violence-related) injuries. Injury Prevention is online only.
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