Abstract
Summary
The aim is to describe the trends in fall-related hospitalisations for older people living in aged care facilities. Over the 9-year period investigated, there were dramatic increases in fall-related hospitalisations. This worrying trend highlights that we may not be addressing falls in aged care facilities sufficiently.
Introduction
The purposes of this study are to describe the trends in fall-related hospitalisations in older people living in aged care facilities and to compare these trends across different demographic groups and injury types.
Methods
This study was conducted in Australia’s second most populous state, Victoria. Aged care facilities in Australia provide high- and low-level nursing care for people who can no longer live independently. Included in this study were hospital admitted episodes of care which met the following criteria: age 65+ years at admission, an admission source indicating a transfer from an aged care facility, an external cause indicating a fall, a care type of ‘acute’, a Victorian postcode of residence, and an admission date between July 1, 2003 and June 30, 2012 (inclusive). Rate denominator data were Victorian aged care bed years.
Results
Over the last 9 years, 7098 episodes of care met the inclusion criteria. The age-standardised rate of hospitalisation increased by 11 % (95 % confidence interval [CI] 9 %, 12 %) per year. Serious injury increased at a slower pace than less serious injury. The slowest rate increase was for hip fracture (incidence rate ratio: 1.03 (95 % CI 1.00, 1.06), the most common fracture type.
Conclusions
Rates of fall-related hospitalisations in older people living in aged care facilities increased at a dramatic pace in the period studied. The relative slower increase in hip fracture may point towards changing referral practices, possible success in osteoporosis management, body mass index increases in older people living in aged care facilities or a combination of these factors.
This is a preview of subscription content, log in via an institution to check access.
References
Cassell E, Clapperton A (2013) A decreasing trend in fall-related hip fracture incidence in Victoria. Aust Osteoporos Int 24(1):99–109
AIHW: Bradley, C., Hospitalisations due to falls by older people, Australia 2008–09. Injury research and statistics series no. 62. Cat. no. INJCAT 138, A.I.o.H.a. Welfare, Editor 2012: Canberra
Hartholt KA et al (2010) Trends in fall-related hospital admissions in older persons in the Netherlands. Arch Intern Med 170(10):905–911
Harvey LA, Close JC (2012) Traumatic brain injury in older adults: characteristics, causes and consequences. Injury 43(11):1821–6
Delbaere K et al (2008) Development and validation of fall risk screening tools for use in residential aged care facilities. Med J Aust 189(4):193–6
Guilley E et al (2008) Reversal of the hip fracture secular trend is related to a decrease in the incidence in institution-dwelling elderly women. Osteoporos Int 19(12):1741–1747
Productivity Commission, Trends in Aged Care Services: some implications, Commission Research Paper, 2008: Canberra
National Centre for Classification in Health, International Statistical classification of diseases and related health problems,10th revision, Australian modification (ICD-10-AM), 7th Edn, 2010
Davie G, Cryer C, Langley J (2008) Improving the predictive ability of the ICD-based injury severity score. Inj Prev 14(4):250–255
Fleiss JL, Levin BA, Paik MC, Statistical methods for rates and proportions. Wiley series in probability and statistics2003: Hoboken, N.J. : J. Wiley, c2003. 3rd ed. / Joseph L. Fleiss, Bruce Levin, Myunghee Cho Paik
Fisher AA, O’Brien ED, Davis MW (2009) Trends in hip fracture epidemiology in Australia: possible impact of bisphosphonates and hormone replacement therapy. Bone 45(2):246–253
Lapane KL, Resnik L (2005) Obesity in nursing homes: an escalating problem. J Am Geriatr Soc 53(8):1386–1391
Tang XY et al (2013) Obesity and risk of hip fracture in adults: a meta-analysis of prospective cohort studies. Plos One 8(4)
Zhang XZ et al (2010) Trends in the prevalence and comorbidities of diabetes mellitus in nursing home residents in the United States: 1995–2004. J Am Geriatr Soc 58(4):724–730
Australian Institute of Health and Welfare, Dementia in Australia, 2012, AIHW: Canberra
Maurer MS, Burcham J, Cheng H (2005) Diabetes mellitus is associated with an increased risk of falls in elderly residents of a long-term care facility. J Gerontol Ser A-Biol Sci Med Sci 60(9):1157–1162
Kropelin TF et al (2013) Fall determinants in older long-term care residents with dementia: a systematic review. Int Psychogeriatr 25(4):549–563
Barker AL et al (2012) Mobility has a non-linear association with falls risk among people in residential aged care: an observational study. J Physiother 58(2):117–125
Polinder S et al (2008) International variation in clinical injury incidence: exploring the performance of indicators based on health care, anatomical and outcome criteria. Accid Anal Prev 40(1):182–191
Cameron ID et al (2012) Interventions for preventing falls in older people in care facilities and hospitals. Cochrane Database Syst Rev 12, CD005465
Bischoff-Ferrari HA et al (2012) A pooled analysis of vitamin D dose requirements for fracture prevention. N Engl J Med 367(1):40–49
Duque G et al (2010) Treatment for osteoporosis in Australian residential aged care facilities: consensus recommendations for fracture prevention. Med J Aust 193(3):173–179
Acknowledgments
The authors thank the Analysis and Evaluation Section, Ageing and Aged Care Division at the Australian Government Department of Health and Ageing.
Conflicts of interest
None.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Russell, M., Clapperton, A., Vu, T. et al. Trends in fall-related hospitalisations in older people living in aged care facilities. Osteoporos Int 26, 1219–1224 (2015). https://doi.org/10.1007/s00198-014-2946-4
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00198-014-2946-4