Unintentional injuries treated in hospital emergency departments among persons aged 65 years and older, United States, 2006-2011

Abstract

Introduction: With the aging of the United States population, unintentional injuries among older adults, and especially falls-related injuries, are an increasing public health concern.

Methods: 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.

Results: 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.

Conclusion: 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.

Practical applications: 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.

Keywords: Elderly; Emergency department; Falls; Older adults; Unintentional injury.

Fig. 1.

Rates for unintentional injury-related emergency department visits for persons aged 65 and older by age group and mechanism of injury, United States, 2011. (Data are from the US Agency for Healthcare Research and Quality, Healthcare Cost and Utilization Project—National Emergency Department Sample.)

Fig. 2.

Rates of unintentional fall-related injury emergency department visits for persons aged 65 and older by age group and body region injured, United States, 2011. (474,830 (21.5%) weighted records with other than listed body region and/or nature of injury are not displayed. Data are from the US Agency for Healthcare Research and Quality, Healthcare Cost and Utilization Project—National Emergency Department Sample.)

Fig. 3.

Proportion of unintentional injury-related emergency department visits for persons aged 65 and older by age group and expected primary payer, United States, 2011. (Data are from the US Agency for Healthcare Research and Quality, Healthcare Cost and Utilization Project—National Emergency Department Sample.)