Miller Gabrielle F, Haddad Yara K, Ortmann Neil, Florence Curtis
National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.
Inj Prev. 2025 Jul 10. doi: 10.1136/ip-2025-045725.
Falls are a leading preventable cause of death and injury among older adults (65+). Healthcare spending in the USA on non-fatal falls was estimated at $80 billion in 2020. We aim to estimate healthcare spending on older adult non-fatal falls by state.
Healthcare spending for all adults was derived from the 2020 Centers for Medicare and Medicaid Services (CMS) Health Expenditures by State of Residence files. These data covered three payor types: Medicare, Medicaid and private health insurance (PHI). Using the national 2020 CMS Health Expenditure by Age Group files, the national proportion of healthcare spending for older adults was calculated for each payor type. These national proportions were applied to each state's healthcare spending data to estimate healthcare spending for older adults in each state, adjusted for the proportion of older adults in each state. To estimate the proportion of older adult healthcare spending attributed to non-fatal falls, these adjusted values were combined with the falls-attributable expenditure factors calculated in Haddad (2024). The final state-level estimates of healthcare spending on non-fatal older adult falls were calculated for each payer type: Medicare, Medicaid and PHI. All estimates were inflated to 2023 dollars.
Overall state-level spending on non-fatal falls ranged between $112.7 million in Alaska to $8.3 billion in Florida. Per-capita spending estimates ranged between $1085 in Utah to $2262 in Wisconsin.
Measuring the cost of non-fatal falls at the state level can help inform regional differences and improve targeted fall prevention efforts.
跌倒是65岁及以上老年人死亡和受伤的主要可预防原因。2020年,美国在非致命跌倒方面的医疗支出估计为800亿美元。我们旨在按州估算老年人非致命跌倒的医疗支出。
所有成年人的医疗支出数据来自2020年医疗保险和医疗补助服务中心(CMS)按居住州划分的医疗支出文件。这些数据涵盖三种付款人类型:医疗保险、医疗补助和私人健康保险(PHI)。利用2020年CMS按年龄组划分的全国医疗支出文件,计算每种付款人类型中老年人医疗支出的全国占比。将这些全国占比应用于每个州的医疗支出数据,以估算每个州老年人的医疗支出,并根据每个州老年人的比例进行调整。为了估算归因于非致命跌倒的老年人医疗支出比例,将这些调整后的值与哈达德(2024年)计算的跌倒归因支出因素相结合。针对每种付款人类型(医疗保险、医疗补助和PHI)计算了老年人非致命跌倒的最终州级医疗支出估算值。所有估算值均按2023年美元进行了通胀调整。
非致命跌倒的州级总体支出范围从阿拉斯加的1.127亿美元到佛罗里达的83亿美元不等。人均支出估算范围从犹他州的1085美元到威斯康星州的2262美元不等。
在州一级衡量非致命跌倒的成本有助于了解区域差异,并改善有针对性的跌倒预防工作。