Objective:To determine whether fall calls, lift assists, and need for transport to the hospital over the past 10 years in one emergency medical services (EMS) system have altered coincident with demographic changes and to estimate health-care cost for lift assists.Methods:We conducted a retrospective chart review of EMS fall-related care. The HealthEMS database for a suburban community surveyed was queried from March 1, 2007, to March 1, 2017. Fall-related calls in patients 60 years or older were identified and determined to be either lift assists (calls that do not result in transport) or fall calls that resulted in transport to the hospital.Results:Of the 38 237 EMS care responses in patients 60 years or older, 11.5% were related to falls. Fall calls increased by 268% over the past 10 years (P = .0006), yet the number of transports to the hospital significantly decreased over time (P = .02). Lift assists increased significantly (P = .0003), nearly doubling over the decade. At the same time, fall calls that did not result in transport to the hospital cost the community an estimated US$1.5 million over a 10-year period.Discussion:There has been a dramatic shift in fall-related calls to EMS in older individuals with more frequent calls for lesser acuity needs. Utilization of EMS for lift assists has substantial financial consequences and diverts care from calls that need immediate triage and transport to care.Conclusion:Future work to reduce the frequency and increase the impact of EMS lift assists could have a significant cost benefit and provide opportunity for enrollment in appropriate community services and fall prevention programs.
Certain older individuals are at risk of having multiple fall-related calls to EMS over short periods of time, sometimes within hours of previous calls. In our current healthcare system, no significant intervention or follow-up is offered or available by emergency first response teams to prevent subsequent falls. This study demonstrates the need for a paradigm change in our healthcare system that helps reduce resource utilization for the first responder community for fall-related calls in older adults and re-directs those resources to implement nationwide fall-prevention strategies to decrease fall related disability and death.
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