Skip to main content
Journal of Epidemiology and Community Health logoLink to Journal of Epidemiology and Community Health
. 2003 Sep;57(9):740–744. doi: 10.1136/jech.57.9.740

Incidence and costs of unintentional falls in older people in the United Kingdom

P Scuffham 1, S Chaplin 1, R Legood 1
PMCID: PMC1732578  PMID: 12933783

Abstract

Study objective: To estimate the number of accident and emergency (A&E) attendances, admissions to hospital, and the associated costs as a result of unintentional falls in older people.

Design: Analysis of national databases for cost of illness.

Setting: United Kingdom, 1999, cost to the National Health Service (NHS) and Personal Social Services (PSS).

Participants: Four age groups of people 60 years and over (60–64, 65–69, 70–74, and ⩾75) attending an A&E department or admitted to hospital after an unintentional fall. Databases analysed were the Home Accident Surveillance System (HASS) and Leisure Accident Surveillance System (LASS), and Hospital Episode Statistics (HES).

Main results: There were 647 721 A&E attendances and 204 424 admissions to hospital for fall related injuries in people aged 60 years and over. For the four age groups A&E attendance rates per 10 000 population were 273.5, 287.3, 367.9, and 945.3, and hospital admission rates per 10 000 population were 34.5, 52.0, 91.9, and 368.6. The cost per 10 000 population was £300 000 in the 60–64 age group, increasing to £1 500 000 in the ⩾75 age group. These falls cost the UK government £981 million, of which the NHS incurred 59.2%. Most of the costs (66%) were attributable to falls in those aged ⩾75 years. The major cost driver was inpatient admissions, accounting for 49.4% of total cost of falls. Long term care costs were the second highest, accounting for 41%, primarily in those aged ⩾75 years.

Conclusions: Unintentional falls impose a substantial burden on health and social services.

Full Text

The Full Text of this article is available as a PDF (126.7 KB).

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Ballaro A., Oliver S., Emberton M. Do we do what they say we do? coding errors in urology. BJU Int. 2000 Mar;85(4):389–391. doi: 10.1046/j.1464-410x.2000.00471.x. [DOI] [PubMed] [Google Scholar]
  2. Buchner D. M., Hornbrook M. C., Kutner N. G., Tinetti M. E., Ory M. G., Mulrow C. D., Schechtman K. B., Gerety M. B., Fiatarone M. A., Wolf S. L. Development of the common data base for the FICSIT trials. J Am Geriatr Soc. 1993 Mar;41(3):297–308. doi: 10.1111/j.1532-5415.1993.tb06708.x. [DOI] [PubMed] [Google Scholar]
  3. Carter N. D., Kannus P., Khan K. M. Exercise in the prevention of falls in older people: a systematic literature review examining the rationale and the evidence. Sports Med. 2001;31(6):427–438. doi: 10.2165/00007256-200131060-00003. [DOI] [PubMed] [Google Scholar]
  4. Dixon J., Sanderson C., Elliott P., Walls P., Jones J., Petticrew M. Assessment of the reproducibility of clinical coding in routinely collected hospital activity data: a study in two hospitals. J Public Health Med. 1998 Mar;20(1):63–69. doi: 10.1093/oxfordjournals.pubmed.a024721. [DOI] [PubMed] [Google Scholar]
  5. Feder G., Cryer C., Donovan S., Carter Y. Guidelines for the prevention of falls in people over 65. The Guidelines' Development Group. BMJ. 2000 Oct 21;321(7267):1007–1011. doi: 10.1136/bmj.321.7267.1007. [DOI] [PMC free article] [PubMed] [Google Scholar]
  6. Gibson N., Bridgman S. A. A novel method for the assessment of the accuracy of diagnostic codes in general surgery. Ann R Coll Surg Engl. 1998 Jul;80(4):293–296. [PMC free article] [PubMed] [Google Scholar]
  7. Gillespie L. D., Gillespie W. J., Robertson M. C., Lamb S. E., Cumming R. G., Rowe B. H. Interventions for preventing falls in elderly people. Cochrane Database Syst Rev. 2001;(3):CD000340–CD000340. doi: 10.1002/14651858.CD000340. [DOI] [PubMed] [Google Scholar]
  8. Hill-Westmoreland Elizabeth E., Soeken Karen, Spellbring Ann Marie. A meta-analysis of fall prevention programs for the elderly: how effective are they? Nurs Res. 2002 Jan-Feb;51(1):1–8. doi: 10.1097/00006199-200201000-00002. [DOI] [PubMed] [Google Scholar]
  9. Judge J. O., Schechtman K., Cress E. The relationship between physical performance measures and independence in instrumental activities of daily living. The FICSIT Group. Frailty and Injury: Cooperative Studies of Intervention Trials. J Am Geriatr Soc. 1996 Nov;44(11):1332–1341. doi: 10.1111/j.1532-5415.1996.tb01404.x. [DOI] [PubMed] [Google Scholar]
  10. Macaulay E. M., Cooper G. G., Engeset J., Naylor A. R. Prospective audit of discharge summary errors. Br J Surg. 1996 Jun;83(6):788–790. doi: 10.1002/bjs.1800830619. [DOI] [PubMed] [Google Scholar]
  11. Oliver D., Hopper A., Seed P. Do hospital fall prevention programs work? A systematic review. J Am Geriatr Soc. 2000 Dec;48(12):1679–1689. doi: 10.1111/j.1532-5415.2000.tb03883.x. [DOI] [PubMed] [Google Scholar]
  12. Province M. A., Hadley E. C., Hornbrook M. C., Lipsitz L. A., Miller J. P., Mulrow C. D., Ory M. G., Sattin R. W., Tinetti M. E., Wolf S. L. The effects of exercise on falls in elderly patients. A preplanned meta-analysis of the FICSIT Trials. Frailty and Injuries: Cooperative Studies of Intervention Techniques. JAMA. 1995 May 3;273(17):1341–1347. [PubMed] [Google Scholar]
  13. Rizzo J. A., Baker D. I., McAvay G., Tinetti M. E. The cost-effectiveness of a multifactorial targeted prevention program for falls among community elderly persons. Med Care. 1996 Sep;34(9):954–969. doi: 10.1097/00005650-199609000-00007. [DOI] [PubMed] [Google Scholar]
  14. Rizzo J. A., Friedkin R., Williams C. S., Nabors J., Acampora D., Tinetti M. E. Health care utilization and costs in a Medicare population by fall status. Med Care. 1998 Aug;36(8):1174–1188. doi: 10.1097/00005650-199808000-00006. [DOI] [PubMed] [Google Scholar]
  15. Robertson M. C., Devlin N., Gardner M. M., Campbell A. J. Effectiveness and economic evaluation of a nurse delivered home exercise programme to prevent falls. 1: Randomised controlled trial. BMJ. 2001 Mar 24;322(7288):697–701. doi: 10.1136/bmj.322.7288.697. [DOI] [PMC free article] [PubMed] [Google Scholar]
  16. Robertson M. C., Devlin N., Scuffham P., Gardner M. M., Buchner D. M., Campbell A. J. Economic evaluation of a community based exercise programme to prevent falls. J Epidemiol Community Health. 2001 Aug;55(8):600–606. doi: 10.1136/jech.55.8.600. [DOI] [PMC free article] [PubMed] [Google Scholar]
  17. Robertson M. C., Gardner M. M., Devlin N., McGee R., Campbell A. J. Effectiveness and economic evaluation of a nurse delivered home exercise programme to prevent falls. 2: Controlled trial in multiple centres. BMJ. 2001 Mar 24;322(7288):701–704. doi: 10.1136/bmj.322.7288.701. [DOI] [PMC free article] [PubMed] [Google Scholar]
  18. Salkeld G., Cameron I. D., Cumming R. G., Easter S., Seymour J., Kurrle S. E., Quine S. Quality of life related to fear of falling and hip fracture in older women: a time trade off study. BMJ. 2000 Feb 5;320(7231):341–346. doi: 10.1136/bmj.320.7231.341. [DOI] [PMC free article] [PubMed] [Google Scholar]
  19. Salkeld G., Cumming R. G., O'Neill E., Thomas M., Szonyi G., Westbury C. The cost effectiveness of a home hazard reduction program to reduce falls among older persons. Aust N Z J Public Health. 2000 Jun;24(3):265–271. doi: 10.1111/j.1467-842x.2000.tb01566.x. [DOI] [PubMed] [Google Scholar]
  20. Tinetti M. E., Williams C. S. Falls, injuries due to falls, and the risk of admission to a nursing home. N Engl J Med. 1997 Oct 30;337(18):1279–1284. doi: 10.1056/NEJM199710303371806. [DOI] [PubMed] [Google Scholar]

Articles from Journal of Epidemiology and Community Health are provided here courtesy of BMJ Publishing Group

RESOURCES