Unintentional injuries treated in hospital emergency departments among persons aged 65 years and older, United States, 2006–2011

deGrauw, Xinyao; Annest, Joseph L.; Stevens, Judy A.; Xu, Likang; Coronado, Victor G.

doi:10.1016/j.jsr.2015.11.002

Cited by 64 publications

(47 citation statements)

References 9 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Each year, accidental falls result in over two million emergency department (ED) visits (1), and fall-related injury care costs exceed $30 billion annually (4). Of particular concern, rates of fall-related ED visits and hospitalizations are increasing (5, 6), and the proportion of older adults in the population is growing, creating an epidemic of falls. Clearly, prevention of falls and the injuries that they cause is a pressing public health issue.…”

Section: Introductionmentioning

confidence: 99%

Adoption of Evidence-Based Fall Prevention Practices in Primary Care for Older Adults with a History of Falls

Phelan

Aerts

Dowler

et al. 2016

Front. Public Health

View full text Add to dashboard Cite

A multifactorial approach to assess and manage modifiable risk factors is recommended for older adults with a history of falls. Limited research suggests that this approach does not routinely occur in clinical practice, but most related studies are based on provider self-report, with the last chart audit of United States practice published over a decade ago. We conducted a retrospective chart review to assess the extent to which patients aged 65+ years with a history of repeated falls or fall-related health-care use received multifactorial risk assessment and interventions. The setting was an academic primary care clinic in the Pacific Northwest. Among the 116 patients meeting our inclusion criteria, 48% had some type of documented assessment. Their mean age was 79 ± 8 years; 68% were female, and 10% were non-white. They averaged six primary care visits over a 12-month period subsequent to their index fall. Frequency of assessment of fall-risk factors varied from 24% (for home safety) to 78% (for vitamin D). An evidence-based intervention was recommended for identified risk factors 73% of the time, on average. Two risk factors were addressed infrequently: medications (21%) and home safety (24%). Use of a structured visit note template independently predicted assessment of fall-risk factors (p = 0.003). Geriatrics specialists were more likely to use a structured note template (p = 0.04) and perform more fall-risk factor assessments (4.6 vs. 3.6, p = 0.007) than general internists. These results suggest opportunities for improving multifactorial fall-risk assessment and management of older adults at high fall risk in primary care. A structured visit note template facilitates assessment. Given that high-risk medications have been found to be independent risk factors for falls, increasing attention to medications should become a key focus of both public health educational efforts and fall prevention in primary care practice.

show abstract

Section: Introductionmentioning

confidence: 99%

Adoption of Evidence-Based Fall Prevention Practices in Primary Care for Older Adults with a History of Falls

Phelan

Aerts

Dowler

et al. 2016

Front. Public Health

View full text Add to dashboard Cite

show abstract

“…Accidental falls occur commonly among older people (1), often cause serious injuries (2, 3), and account for a substantial portion of 9-1-1 calls (4–6). With the growth of the elderly population, this situation is likely to persist or even worsen.…”

Section: Introduction Background and Rationalementioning

confidence: 99%

Coordinating Care for Falls via Emergency Responders: A Feasibility Study of a Brief At-Scene Intervention

Phelan

Herbert

Fahrenbruch

et al. 2016

Front. Public Health

View full text Add to dashboard Cite

Falls account for a substantial portion of 9-1-1 calls, but few studies have examined the potential for an emergency medical system role in fall prevention. We tested the feasibility and effectiveness of an emergency medical technician (EMT)-delivered, at-scene intervention to link elders calling 9-1-1 for a fall with a multifactorial fall prevention program in their community. The intervention was conducted in a single fire department in King County, Washington and consisted of a brief public health message about the preventability of falls and written fall prevention program information left at scene. Data sources included 9-1-1 reports, telephone interviews with intervention department fallers and sociodemographically comparable fallers from three other fire departments in the same county, and in-person discussions with intervention department EMTs. Interviews elicited faller recall and perceptions of the intervention, EMT perceptions of intervention feasibility, and resultant referrals. Sixteen percent of all 9-1-1 calls during the intervention period were for falls. The intervention was delivered to 49% of fallers, the majority of whom (75%) were left at scene. Their mean age (N = 92) was 80 ± 8 years; 78% were women, 39% had annual incomes under $20K, and 34% lived alone. Thirty-five percent reported that an EMT had discussed falls and fall prevention (vs. 8% of comparison group, P < 0.01); 84% reported that the information was useful. Six percent reported having made an appointment with a fall prevention program (vs. 3% of comparison group). EMTs reported that the intervention was worthwhile and did not add substantially to their workload. A brief, at-scene intervention is feasible and acceptable to fallers and EMTs. Although it activates only a small percent to seek out fall prevention programs, the public health impact of this low-cost strategy may be substantial.

show abstract

“…1 However, traumatic injury in older adults is increasing in prevalence as the US population ages. 2 Older patients present unique care challenges because they have decreased physiologic reserve, have more comorbid conditions, and are at risk of specific complications such as delirium. 3 Our objective was to quantify occurrence of and spending on traumatic injury in comparison with other common medical diseases resulting in acute hospitalization among Medicare beneficiaries.…”

mentioning

confidence: 99%

Prevalence and Payments for Traumatic Injury Compared With Common Acute Diseases by Episode of Care in Medicare Beneficiaries, 2008-2014

Montgomery

Cain‐Nielsen

Jenkins

et al. 2019

JAMA

View full text Add to dashboard Cite

The burden of traumatic injury among older adults is underappreciated, as it is the predominant cause of death among children and younger adults and therefore often thought to be primarily a disease of the young. 1 However, traumatic injury in older adults is increasing in prevalence as the US population ages. 2 Older patients present unique care challenges because they have decreased physiologic reserve, have more comorbid conditions, and are at risk of specific complications such as delirium. 3 Our objective was to quantify occurrence of and spending on traumatic injury in comparison with other common medical diseases resulting in acute hospitalization among Medicare beneficiaries. Methods | We evaluated Centers for Medicare & MedicaidServices Parts A and B claims data for inpatient hospitalizations among adults aged 65 years or older with fee-forservice Medicare coverage from 2008 to 2014 (the most recent data available to our research group) using a nationally representative 20% sample. We computed all index hospitalization, readmission, and postacute care (skilled nursing facility, long-term acute care facility, inpatient rehabilitation, and outpatient Part B) payments within 90 days of discharge. Payments were categorized according to primary indication for hospitalization based on the first International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) code listed for each episode. Traumatic injury was defined as a first-position ICD-9-CM code from 800 to 959.9, excluding late effects, superficial injuries, or foreign bodies entering through orifice. 4 Additional ICD-9-CM diagnosis groupings were created for congestive heart failure, pneumonia, stroke, and acute myocardial infarction. These diagnosis groupings were chosen because they represent common acute diseases among Medicare beneficiaries.Analyses were performed using SAS version 9.4 (SAS Institute Inc). Proportions of inpatient hospitalizations and Medicare payments were compared between disease categories using 2-sided z tests or t tests. 95% Wald confidence intervals were constructed. Statistical significance was set at P < .005 to account for multiple comparisons. Payment data are presented in real dollars (not inflation adjusted). The Michigan Medicine Institutional Review Board approved this study with a waiver of informed consent.

show abstract

Unintentional injuries treated in hospital emergency departments among persons aged 65 years and older, United States, 2006–2011

Cited by 64 publications

References 9 publications

Adoption of Evidence-Based Fall Prevention Practices in Primary Care for Older Adults with a History of Falls

Adoption of Evidence-Based Fall Prevention Practices in Primary Care for Older Adults with a History of Falls

Coordinating Care for Falls via Emergency Responders: A Feasibility Study of a Brief At-Scene Intervention

Prevalence and Payments for Traumatic Injury Compared With Common Acute Diseases by Episode of Care in Medicare Beneficiaries, 2008-2014

Contact Info

Product

Resources

About