Fall-related injuries in residential aged care facilities could be costing the health system $325m annually, say Australian researchers.
The average cost of a single injury-causing fall in an aged care facility is about $2500, say Queensland researchers.
And the University of Queensland’s Centre for Health Service Research study also found fall injuries accounted for 20% of annual expenditure on an aged care resident between 2021 and 2022.
The findings were published in the Injury Prevention journal. The authors said their study was the first to value the economic burden of fall injury in Australia’s residential aged care (RAC) system for all levels of care and “the first to assess the residents’ characteristics associated with fall injury in Australia’s RAC”.
Dr Charles Okafor, a research fellow at the centre, said falls remained a significant and costly problem in Australian residential aged care facilities.
“We monitored 303 people aged over 65 [years] in aged care facilities in New South Wales and Western Australia, and found the average cost of a fall resulting in injury was around $2500,” he said.
“A total of 281 residents had falls, but only 119 of the residents had fall injuries, so the potential cost of fall injuries to Australia’s health care system was $325 million a year.
“Falls pose a significant financial burden but despite efforts to address the issue over the years, falls continue to remain a significant problem.”
Of the 281 residents who had falls, 22.8% had a single fall injury, 19.6% had two or more injurious falls, while 57.6% had non-injurious fall. The average age of the 281 residents who had injurious falls was 85.3 years, and 76.5% were females.
The most common injurious falls were injuries to shoulder, arm, elbow, knee, leg and ankle, the researchers found.
According to the paper, falls are the leading cause of injury hospitalisation and deaths in Australia, accounting for 43% of all injury hospitalisations.
“Fall injury has emerged as a critical public health problem since the proportion of the Australian population aged 65 years and over will increase to around 25% by 2050, comparable to the rising trajectory of people aged 65 years and over worldwide,” the authors wrote.
They found about 60% of older Australians living in residential aged care had experienced a fall incident, and one in five of falls in Australia that result in hospitalisation occurred in an aged care facility.
The study also found body mass index (BMI) and gender were the two major factors linked to a high falls risk. The BMI finding was very significant, the authors wrote.
“We found male residents were twice as likely to suffer a fall-related injury and those with a normal BMI were also at higher risk,” Dr Okafor said.
“Residents with a normal BMI are possibly more independent and not as closely monitored as those who could be overweight or underweight and less mobile.
“The falls risk profile is completely different for those living in the community which means we need different approaches for different populations.”
The researchers explained this in more detail in the paper.
“In comparison to a recent study that assessed the association of BMI and falls in community-dwelling adults and demonstrated that both underweight and obesity were associated with increased falls risk, compared with normal weight (U-shaped relationship), our findings were different but justifiable,” they wrote.
“In the community, older people who are underweight, overweight and frail are still engaging in activities that increase risk of fall by moving about in the community and in their home with minimal care support.
“Hence, they fall more frequently relative to their counterparts in RACs who are highly monitored, spend more time on bed and are dependent on staff for undertaking mobility tasks.”
While a national prevention strategy is in place through the Australian and New Zealand Falls Prevention Society, Dr Okafor said more was needed to create a strategy specifically for aged care residents.
“Successful examples like the National Ageing Research Institute’s falls prevention in residential aged care workshops could be used as models for implementation nationwide,” he said.
“This could come about by liaising with stakeholders to find out what the training needs of aged care staff are, the challenges they’re facing, and what could minimise costs.”Injury Prevention 2025, 13 January