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Statistics are used to measure the significant impact of falls and fall related injury on the population. Having a fall is the leading cause of unintentional injury for Queenslanders aged 65 years and over. This section provides information on:
Falls statistics are available from international, national and state data sources. For more information visit Data Sources.
The following measures are used to gauge the significance of falls and fall related injury as a public health problem in Queensland:
Prevalence
Prevalence measures the proportion of people in the population who have a condition during a specified time period [86]. Older people are at greatest risk of sustaining an injury from a fall. At least one in four older people have a fall each year. Over 40 per cent have multiple falls and over 30 per cent require medical attention after a fall [214]. The rate of falls is even higher for older people living in residential care [73].
Burden of Disease
"The burden of disease measures the gap between the current health status and the ideal situation where everyone lives into old age free of disease and disability. It can be used to measure the total impact of falls and falls related injury, judged by years of life lost due to disability and premature mortality" [88].
In 2003, falls related injury in Queenslanders aged 65 years and older accounted for 1.5 per cent of the total burden of disease and injury (59 per cent of this burden was due to premature death and 41 per cent due to years lived with disability). The falls related burden for females aged 65 years and older was about double that of the male burden (1.0 per cent for males and 1.9 per cent for females). Burden of disease studies project a continuing increase in falls related disability burden.
For more information on the impact on quality of life from falls in Queensland, see statistics on burden of falls.
Morbidity
Morbidity measures non-fatal outcomes from fall related injury including hip fractures and the treatment provided by the health system [87]. The most common forms of fall related injury data are:
The amount of morbidity associated with fall related injury remains an incomplete picture as this data is not routinely collected and reported by all health services that provide treatment for falls (for example: general practitioners) [87].
In Queensland in 2004/05, there were 17,966 hospitalisations for falls in people aged 65 years and older, of which 67 per cent were female. In the same period, falls in people aged 65 years and older accounted for 229,698 patient days in Queensland's public and private acute hospitals. The average number of patient days for females (12.8 days per patient) was slightly higher than for males (12.5 days per patient).
Over recent decades, hospital morbidity for fall related injuries in people aged 65 years and older has increased. Population increase in older age groups and increased life expectancy is projected to drive higher rates of fall related morbidity, unless successful prevention programs are implemented.
Rates of hospitalisation for fall related injury in people aged 65 years and older in Queensland (3,924 separations per 100,000 persons) in 2004/05 were lower than the national average (4,198 separations per 100,000 persons).
For more information on deaths due to falls in Queensland, see falls morbidity.
Mortality
A death from an injury or a fall is the most serious outcome. Mortality measures the number of injury deaths in the population during a set time period [87].
From 2000 to 2005, there were on average 107 deaths of people aged 65 years and older from falls injury in Queensland each year, with about 48 per cent of these occurring in the very elderly (85 years and older). Rates of death from falls have remained steady in recent years. Inconsistencies of data relating to deaths from falls preclude time trend analysis with earlier periods.
For more information on the number of deaths from falls in Queensland, see falls mortality.
One particular impact of falls in older people is the number and severity of hip fractures. These injuries are a feature of falls in older people and can be used as one very rough indicator of the overall impact of the falls in older people living in the community.
Falls are caused by many factors these include:
Most falls are preventable and predictable [67]. There are a number of interactive risk factors for falling, with the risk of falling increasing as the number of factors accumulates. To prevent falls, several risk factors need to be addressed. Addressing multiple risk factors is known as a multi-factorial approach.
About one quarter (26 per cent) of falls in people of all ages in developed countries of the world could be prevented by environmental interventions [215]. These interventions include improving the housing environment, limiting access to building sites and improving the safety of recreational environments.
For more information on the risk factors for falls, visit Queensland Stay On Your Feet® Community Good Practice Guidelines.
There are three common methods used to report the cost of falls:
To deal with the burden of disease, you need to select interventions that are known to be effective, efficient and equitable. Ask and answer these questions:
To determine if a falls prevention program is effective, the cost of implementing the program is often compared with the cost of the number of falls prevented by the program. An economic analysis of a community-based falls prevention program was completed by the Stay on Your Feet® project in Northern Rivers, New South Wales, conducted during 1992 and 1997.
As the population ages, falls and fall related injury are a major health issue for health systems throughout the developed world. This is particularly important for Queensland because in addition to ageing, the population is growing rapidly and is projected to continue to grow. In the next 20 to 50 years, the number of people aged 65 years and older in Queensland is expected to more than triple, and increase as a proportion of the total population. In 2007, one in eight people in Queensland are aged 65 years or older. By 2051, it is projected that one in four Queenslanders will be aged 65 years or older.
For more information on Queensland’s ageing population, see ageing population.
Total hospital costs for falls were assessed in 2001 as $54 million. These costs are projected to quadruple in the next 40 to 50 years [3]. Taking into account all costs including general practitioners, nursing homes, specialists and pharmacy, the projected costs are set to increase to $320 million by 2051 [3].
Unless effective preventative strategies are put in place, the cost of care and services associated with fall related injury in older people will absorb a significant proportion of the increased spending on the health of older people [3]. Specifically, with the ageing of the population, the number of hip fractures in Australia is expected to double by 2026 and increase four fold by 2051, based on current incidence rates [216].
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