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     Among Seniors
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Initial Report on Public Health
Fall-Related Hospitalizations Among Seniors
Narrative

The fall-related hospitalization rate indicator estimates the age-standardized number of injury-related hospital separations that are due to falls in seniors age 65 years and older per 100,000 population.

Persons over age 65 have the highest mortality rate from injuries. In the elderly, injuries from falls cause about one-half of deaths due to injury - more than either pneumonia or diabetes. 96, 97

Injury prevention is a cost-effective strategy for reducing the indirect and direct health care costs associated with falls. 98, 99 Effective injury prevention interventions can reduce injury-associated demand for care, including reducing hospitalizations, the demand for rehabilitation and assistive devices, as well as for residential care and home care. 100, 101 Injury prevention can also help seniors preserve their independence and quality of life - avoiding clinical complications and increased dependency on support services. 102, 103

Most falls are predictable and therefore, preventable. Public health injury prevention interventions focus on eliminating or reducing known risk factors associated with falling.

Public health programs and services focus on reducing the frequency, severity, and impact of preventable injury. Public health units and their community partners promote:

  • the safe use of prescription and over-the-counter medication
  • the importance of nutrition and calcium and Vitamin D rich foods combined with exercise to prevent falls and/or delay the onset of osteoporosis
  • awareness of the built environment and the identification of hazards to reduce the risk of falling both in the home and in the community

The risk of being injured and the incidence of injury are not equal throughout Ontario; each age group is at risk for different types of injuries. Seniors are most at risk for serious injuries resulting from changes that occur during the aging process (e.g. decreased vision, diminished reflexes, reduced muscular strength and mass, and decreased bone density).

In 2007, the rate of injury-related hospital separations due to falls in seniors age 65 years and older was 1,309.5 per 100,000 seniors in Ontario. Based on 36 public health units in Ontario, the highest rate was 2,371.5 and the lowest rate was 942.6 injury-related hospital separations due to falls in seniors age 65 years and older, per 100,000 population.

Indicator Definition

Definition:

The fall-related hospitalization rate indicator estimates the age-standardized number of injury-related hospital separations that are due to falls in seniors age 65 years and older per 100,000 population.

Data Source(s):

Numerator: Discharge Abstract Database, Canadian Institute for Health Information
Distributed by Population Health Planning Database, Ministry of Health and Long-Term Care
Denominator: Population Estimates, Population Health Planning Database, Ministry of Health and Long-Term Care

Formula:

Number of hospital separations due to falls In those age 65+ years (2007 calendar year)

Total population age 65+ years (2007 calendar year)
 
x 100,000

Notes:

  • Age groups in years for direct age-standardization: 65-74, 75-85, and 85+
  • Direct age-standardization to the 1991 Canadian population
  • Includes Accidental Falls (ICD-10-CA: W00-W19) with external causes
  • PHPDB Qualifications: Calendar Year (2007); Ages (greater than or equal to 65); Patient diagnosis beginning with W0 or W1 in ICD-10-CA Block Codes including diagnosis with external cause diagnoses
  • IntelliHealth\Shared Reports\PHU\Fall Related Hospitalizations 65120

96 National Safety Council. Falls leading cause of injury death for people 65 and older [press release]. May 7, 2008. Retrieved April 23, 2009 from: http://www.nsc.org/news/nr050708.aspx.
97 Public Health Agency of Canada, Division of Aging and Seniors. Report on seniors’ falls in Canada. Ottawa, ON: Minister of Public Works and Government Services Canada; 2005. Retrieved April 23, 2009 from: http://www.phac-aspc.gc.ca/seniors-aines/pubs/seniors_falls/pdf/seniors-falls_e.pdf.
98 Stevens JA, Corso PS, Finkelstein EA, Miller TR. The costs of fatal and non-fatal falls among older adults. Inj Prev. 2006 Oct;12(5):290-5. Retrieved August 5, 2009 from: http://injuryprevention.bmj.com/cgi/reprint/12/5/290.pdf.
99 Tiedemann AC, Murray SM, Munro B, Lord SR. Hospital and non-hospital costs for fall-related injury in community-dwelling older people. N S W Public Health Bull. 2008 Sep-Oct;19(9-10):161-5.
100 SMARTRISK. The economic burden of injury in Ontario. Toronto: Smartrisk; 2006. p. 47-48. Retrieved August 5, 2009 from: http://www.oninjuryresources.ca/downloads/Ontario_Economic_Burden_of_Injury.pdf.
101 Beard J, Rowell D, Scott D, van Beurden E, Barnett L, Hughes K, Newman B. Economic analysis of a community-based falls prevention program. Public Health. 2006 Aug;120(8):742-51. Epub 2006 Jul 5.
102 Ontario Injury Prevention Resource Centre. Falls across the lifespan: evidence-based practice synthesis document. Toronto: Smartrisk; 2008. Retrieved August 5, 2009 from: http://www.oninjuryresources.ca/downloads/misc/FallsReview-D8.pdf.
103 Public Health Agency of Canada. Report on seniors' falls in Canada. Ottawa: Public Health Agency of Canada; 2005. Retrieved August 5, 2009 from: http://www.phac-aspc.gc.ca/seniors-aines/pubs/seniors_falls/pdf/seniors-falls_e.pdf.

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