10% of seniors' ED visits related to falls

Falls continue to be a serious problem for elderly patients. Seniors who hurt themselves in falls made more than 2.1 million emergency department visits in 2006, according to a report released in October by the Agency for Healthcare Research and Quality.

One in 10 visits to the ED among adults 65 and older were related to a fall, according to the report (link).

Thirty percent of these patients had to be admitted to the hospital, with ED costs totaling $6.8 billion. The cost of all medical care directly related to falls is about $20 billion.

The problem appears to be getting worse, according to Ryan Mutter, PhD, an author of the study and a staff economist with AHRQ's Center for Delivery, Organization, and Markets. He said that the number of fall-related visits among seniors was up 6% from 2005.

Forty-one percent of older patients injured in falls had fractures, and four in 10 of those patients were transferred to nursing homes or other long-term-care facilities. Five percent of all fall patients had injuries to internal organs.

There are some things doctors can do to help elderly patients who have a history of falls, said another study author, William Spector, PhD. Physicians should assess patients with gait and balance problems, with one part of the assessment being a simple observation of how well they sit and then rise from the seated position.

Doctors should "encourage elderly [patients] to participate in exercise programs with balance and strength training," said Spector, a health services researcher in AHRQ's CDOM who specializes in research on long-term care and the elderly. And review medications to see if there is a way to minimize those that contribute to drowsiness or instability, he said.

Spector said other steps that have proven effective at reducing falls among the elderly include:

• Muscle strengthening and balance training at home, prescribed by a physician or other trained health professional.
• Tai chi exercise programs.
• Home hazard assessment and modification.
• Withdrawal of psychotropic medications, if possible.