The cost of falls among the community-dwelling elderly.

OBJECTIVE To estimate the direct medical costs of falls in the population of community-dwelling elderly. METHODS Data from a sample of 4,025 consumers from the 1997 Medical Expenditure Panel Survey were used to make estimates that were representative of the population of civilian, noninstitutionalized elderly in the United States. RESULTS In 1997, 9% of the noninstitutionalized elderly population of the United States reported medical conditions related to falls. The estimated total direct medical cost of these conditions was dollar 6.2 billion in 1997 dollars and dollar 7.8 billion in 2002 dollars. The mean cost per person who had fallen was dollar 2,039 in 1997 dollars and dollar 2,591 in 2002 dollars. Inpatient hospitalizations accounted for 65% of total costs, followed by office-based medical visits and home health care, each accounting for about 10% of total direct medical costs, and hospital outpatient visits for 7.6%. About 78% of fall-related costs were reimbursed by Medicare. CONCLUSION Fall-related medical conditions affect a substantial number of the community-dwelling elderly and result in direct medical costs of dollar 6 to dollar 8 billion per year in the United States. The total economic burden of falls is significantly higher because this estimate does not include direct nonmedical, intangible, and indirect costs. The results of this study highlight the importance of research aimed at decreasing the incidence and severity of falls in the elderly.