One in three people aged over 65, and half of those aged over 80, fall at least once a year. Falls cost the NHS more than £2 billion per year. With the number of people aged 65 and over predicted to increase by 2 million by 2021, the costs incurred of treating patients across health, community and social care services are set to rise further. This paper uses Torbay’s unique patient-level linked data set to explore the NHS and social care costs of the care pathway for older people in the 12 months before and after being admitted to hospital as a result of a fall. On average, these costs for each patient who fell were almost four times as much in the 12 months after admission for a fall as the costs of the admission itself. Over the 12 months that followed admission for falls, costs were 70% higher than in the 12 months before the fall. Comparing the 12 months before and after a fall, the most dramatic increase was in community care costs (160%), compared to a 37% increase in social care costs and a 35% increase in acute hospital care costs. While falls patients in this study accounted for slightly more than 1% of Torbay’s over-65 population, in the 12 months that followed a fall, spending on their care accounted for 4% of the whole annual inpatient acute hospital spending, and 4% of the whole local adult social care budget. The authors discuss how linked health and social care data can be used to inform policy and practice. The findings strengthen the case for an integrated response for frail older people at risk of falls. However, to allow comparison of different models of care, other localities need to emulate Torbay’s recording and analysis of whole-system data at the patient level - which, to the authors' knowledge, is the first time that such detailed analysis of the costs in the health and social care system has been carried out in relation to falls patients in England.
(Edited publisher abstract)
One in three people aged over 65, and half of those aged over 80, fall at least once a year. Falls cost the NHS more than £2 billion per year. With the number of people aged 65 and over predicted to increase by 2 million by 2021, the costs incurred of treating patients across health, community and social care services are set to rise further. This paper uses Torbay’s unique patient-level linked data set to explore the NHS and social care costs of the care pathway for older people in the 12 months before and after being admitted to hospital as a result of a fall. On average, these costs for each patient who fell were almost four times as much in the 12 months after admission for a fall as the costs of the admission itself. Over the 12 months that followed admission for falls, costs were 70% higher than in the 12 months before the fall. Comparing the 12 months before and after a fall, the most dramatic increase was in community care costs (160%), compared to a 37% increase in social care costs and a 35% increase in acute hospital care costs. While falls patients in this study accounted for slightly more than 1% of Torbay’s over-65 population, in the 12 months that followed a fall, spending on their care accounted for 4% of the whole annual inpatient acute hospital spending, and 4% of the whole local adult social care budget. The authors discuss how linked health and social care data can be used to inform policy and practice. The findings strengthen the case for an integrated response for frail older people at risk of falls. However, to allow comparison of different models of care, other localities need to emulate Torbay’s recording and analysis of whole-system data at the patient level - which, to the authors' knowledge, is the first time that such detailed analysis of the costs in the health and social care system has been carried out in relation to falls patients in England.
(Edited publisher abstract)
Subject terms:
falls, older people, costs, care pathways, NHS, social care, community care;
Journal of Integrated Care, 22(4), 2014, pp.165-173.
Publisher:
Emerald
Purpose: The purpose of this paper is to explore the whole system cost of the care pathway for older people (aged 65-years old and over) admitted to hospitals as a result of falls in Torbay, a community of 131,000 in the southwest of England with a high proportion of older residents, over a two-year period.
Design/methodology/approach:The paper analysed patient-level linked acute hospital, of the admission itself. Over the 12 months that followed admission for falls, costs were 70 per cent higher than in the 12 months before the fall. The most dramatic increase was in community health care costs (160 per cent), compared to a 37 per cent increase in social care costs and a 35 per cent increase in acute hospital care costs. For patients who had a minor fall and those who survived 12 months after
(Publisher abstract)
Purpose: The purpose of this paper is to explore the whole system cost of the care pathway for older people (aged 65-years old and over) admitted to hospitals as a result of falls in Torbay, a community of 131,000 in the southwest of England with a high proportion of older residents, over a two-year period.
Design/methodology/approach:The paper analysed patient-level linked acute hospital, community care and local authority-funded social care data to track patients’ care costs – for those patients admitted to an acute hospital due to their fall – in the 12 months before and after their fall.
Findings: On average, the cost of hospital, community and social care services for each admitted for a fall were almost four times as much in the 12 months after admission, than the cost of the admission itself. Over the 12 months that followed admission for falls, costs were 70 per cent higher than in the 12 months before the fall. The most dramatic increase was in community health care costs (160 per cent), compared to a 37 per cent increase in social care costs and a 35 per cent increase in acute hospital care costs. For patients who had a minor fall and those who survived 12 months after the fall, the costs of care home services increased significantly; for patients with hip fracture, the costs of community care services increased significantly; for patients who did not survive 12 months after the fall, the cost of acute inpatient and community health visits increased significantly.
Originality/value: This is the only study that has assessed the costs across the acute hospital, community care and social care pathway for this group of patients, in an English population. This will help commissioners and providers understand and develop better-integrated responses to frail elderly patients needs.
(Publisher abstract)
Subject terms:
costs, falls, older people, rural areas, communities, systems approach, hospital admission, integrated services, health care, social care, financing;