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The Socioeconomic Implications of Falls

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Due to advancements in healthcare, life expectancy is increasing, particularly within the Western world. In tandem with a recent trend of decreasing birth rates, population structures within many Western countries are set to comprise of a larger proportion of older adults (65+ years of age). Older adults are considered to be the fastest growing age group worldwide: there are forecast to be 1.55 billion older adults across the world by 2050, in comparison to 440 million in 2010. This exponential increase in the older adult population could place a large demand on healthcare services and require them to adapt to the needs of this ever-growing societal group. One such area that would require attention is the prevention and rehabilitation of falls. As alluded to earlier, falls are estimated to cost the NHS over £2.3 billion per year, with 1 in 3 older adults over the age of 65 suffering a least one fall on average every year. Globally, around 37.3 million falls lead to older adults requiring healthcare, and around 646,000 fall-related fatalities.

The socioeconomic cost of falls is set to rise alongside the increasing number of older adults. Therefore, interventions with the intention of preventing falls may alleviate socioeconomic burden. Whilst many studies have evaluated the costs of falls within different countries, such as Ireland, Australia, Holland and Lithuania, it can be challenging to compare results. This can be due to availability of health service statistics, variability in the standard of healthcare, and life expectancy. However, the socioeconomic burden has been consistently demonstrated to be significant. Due to the increasing older adult population, especially within Western countries such as those mentioned, one can expect these costs to increase. Therefore, a successful falls prevention program may help to reduce the socioeconomic burden.

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A report from the Department of Health (2007) claims that if every strategic health authority in England were to invest £2 million towards falls and bone health interventions, £5 million each could be saved in one year, by preventing 400 hip fractures alone. Furthermore, many vulnerable patients are not being provided with suitable falls prevention interventions. Around 28% of 385 older adults who fell in hospital were not reviewed by medical staff within 24 hours, and 22% of older adults who may have experienced a head injury were not neurologically observed following the fall. Irvine et al., (2010) demonstrated the feasibility of a cost effective multifactorial falls intervention program. A randomized trial of 364 participants over the age of 70 were recruited, who had been identified as being of high risk of falling by their GPs.

A range of services were provided, with falls prevention information leaflets distributed to all participants. Those in the intervention group were offered physiotherapy, occupational therapy and medical review at day hospital. The control group did not receive these additional services, only the leaflet. The control group still had access to normal public health services. Over a 12 month period, those in the intervention group suffered fewer falls (2.07 per person/year) in comparison to 2.24 in the control group. The cost per patient in the control group was £349, in comparison to £578 in the intervention group. Analysis indicates £3,302 was saved per fall averted. This indicates that fall prevention programs can help alleviate the financial strain that falls place upon healthcare services in the UK.

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