DeGrauw Xinyao, Annest Joseph L, Stevens Judy A, Xu Likang, Coronado Victor
Rollins School of Public Health, Emory University, 1518 Clifton Road, Atlanta, GA 30322, United States.
National Center for Injury Prevention & Control Centers for Disease Control & Prevention, 4770 Buford Highway, F-62, Atlanta, GA, 30341, United States.
J Safety Res. 2016 Feb;56:105-9. doi: 10.1016/j.jsr.2015.11.002. Epub 2015 Dec 2.
With the aging of the United States population, unintentional injuries among older adults, and especially falls-related injuries, are an increasing public health concern.
We analyzed emergency department (ED) data from the Nationwide Emergency Department Sample, 2006-2011. We examined unintentional injury trends by 5-year age groups, sex, mechanism, body region, discharge disposition, and primary payer. For 2011, we estimated the medical costs of unintentional injury and the distribution of primary payers, plus rates by injury mechanisms and body regions injured by 5-year age groups.
From 2006 to 2011, the age-adjusted annual rate of unintentional injury-related ED visits among persons aged ≥ 65 years increased significantly from 7987 to 8163, per 100,000 population. In 2011, 65% of injuries were due to falls. Rates for fall-related injury ED visits increased with age and the highest rate was among those aged ≥ 100. Each year, about 85% of unintentional injury-related ED visits in this population were expected to be paid by Medicare. In 2011, the estimated lifetime medical cost of unintentional injury-related ED visits among those aged ≥ 65 years was $40 billion.
Increasing rates of ED-treated unintentional injuries, driven mainly by falls among older adults, will challenge our health care system and increase the economic burden on our society. Prevention efforts to reduce falls and resulting injuries among adults aged ≥ 65 years have the potential to increase well-being and reduce health care spending, especially the costs covered by Medicare.
With the aging of the U.S. population, unintentional injuries, and especially fall-related injuries, will present a growing challenge to our health care system as well as an increasing economic burden. To counteract this trend, we must implement effective public health strategies, such as increasing knowledge about fall risk factors and broadly disseminating evidence-based injury and fall prevention programs in both clinical and community settings.
随着美国人口老龄化,老年人中的意外伤害,尤其是与跌倒相关的伤害,日益成为公共卫生关注的焦点。
我们分析了2006年至2011年全国急诊科样本中的急诊科数据。我们按5岁年龄组、性别、机制、身体部位、出院处置方式和主要支付方研究了意外伤害趋势。对于2011年,我们估计了意外伤害的医疗费用以及主要支付方的分布情况,还计算了按伤害机制和5岁年龄组受伤身体部位划分的发生率。
2006年至2011年期间,65岁及以上人群中经年龄调整的与意外伤害相关的急诊科就诊年发生率从每10万人7987例显著增至8163例。2011年,65%的伤害是由跌倒所致。与跌倒相关的急诊科就诊率随年龄增长而上升,100岁及以上人群的发生率最高。每年,该人群中约85%与意外伤害相关的急诊科就诊预计将由医疗保险支付。2011年,65岁及以上人群中与意外伤害相关的急诊科就诊的估计终身医疗费用为400亿美元。
主要由老年人跌倒导致的经急诊科治疗的意外伤害发生率上升,将给我们的医疗保健系统带来挑战,并增加社会的经济负担。减少65岁及以上成年人跌倒及由此导致的伤害的预防措施有可能增进健康并降低医疗保健支出,尤其是医疗保险覆盖的费用。
随着美国人口老龄化,意外伤害,尤其是与跌倒相关的伤害,将给我们的医疗保健系统带来日益严峻的挑战,并造成不断增加的经济负担。为应对这一趋势,我们必须实施有效的公共卫生策略,比如增加对跌倒风险因素的认识,并在临床和社区环境中广泛传播基于证据的伤害和跌倒预防项目。