Scuffham P, Chaplin S, Legood R
York Health Economics Consortium Ltd, University of York, UK.
J Epidemiol Community Health. 2003 Sep;57(9):740-4. doi: 10.1136/jech.57.9.740.
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.
Analysis of national databases for cost of illness.
United Kingdom, 1999, cost to the National Health Service (NHS) and Personal Social Services (PSS).
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).
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 pound 300,000 in the 60-64 age group, increasing to pound 1,500,000 in the >/=75 age group. These falls cost the UK government pound 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.
Unintentional falls impose a substantial burden on health and social services.
估算老年人意外跌倒导致的急诊就诊次数、住院人数及相关费用。
对国家疾病成本数据库进行分析。
英国,1999年,国家医疗服务体系(NHS)和个人社会服务(PSS)的成本。
四个年龄组60岁及以上(60 - 64岁、65 - 69岁、70 - 74岁以及≥75岁)的人群,因意外跌倒后前往急诊部门就诊或住院。所分析的数据库包括家庭意外监测系统(HASS)、休闲意外监测系统(LASS)以及医院事件统计(HES)。
60岁及以上人群中,因跌倒相关损伤而进行的急诊就诊次数为647,721次,住院人数为204,424人。四个年龄组每10,000人口的急诊就诊率分别为273.5、287.3、367.9和945.3,每10,000人口的住院率分别为34.5、52.0、91.9和368.6。60 - 64岁年龄组每10,000人口的成本为300,000英镑,在≥75岁年龄组中增至1,500,000英镑。这些跌倒给英国政府造成了9.81亿英镑的损失,其中NHS承担了59.2%。大部分成本(66%)归因于≥75岁人群的跌倒。主要成本驱动因素是住院治疗,占跌倒总成本的49.4%。长期护理成本位居第二,占41%,主要是在≥75岁的人群中。
意外跌倒给健康和社会服务带来了沉重负担。