A University of Queensland study has identified the cost and factors connected with fall-related injuries within Australian residential aged care.
The research aimed to understand the economic implications of falls among older adults and how to allocate healthcare resources effectively to lower falls and elevate quality of life.
Findings from the research monitoring 303 people aged over 65 in aged care facilities in New South Wales and Western Australia discovered the average cost of a fall resulting in injury was around $2,500 dollars.
According to UQ’s postdoctoral research fellow at the Centre for Health Services Research Dr Charles Okafor, the study found 20 per cent of annual expenditure on an aged care resident between 2021-2022 resulted from falls.
“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 dollars a year,” says Okafor.
“Falls pose a significant financial burden but despite efforts to address the issue over the years, falls continue to remain a significant problem.”
Okafor says the high cost and inverted U-shaped relationship between BMI and falls risk highlights the need for more effective and tailored falls prevention strategies within residential aged care settings.
“I was surprised to learn the extent of healthcare spending on fall injuries in residential aged care (about $325 annually) despite so many financial resources ploughed into the sector,” he tells Australian Ageing Agenda.
Director of the National Ageing Research Institute and professorial fellow at UQ Professor Tracy Comans, co-authored the study alongside Dr Okafor. She tells AAA that the cost was high but not unexpected.
“We know falls remain a significant issue. Not all falls can be prevented however so it is hard to know what is reasonable.”
(Image supplied)
(Image supplied)
Two key findings from the study published in the BMJ discovered that body mass index and gender were the main factors linked to a high falls risk.
Okafor says they found male residents were twice as likely to suffer a fall related injury and those with a normal BMI were also at higher risk.
“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,” he says.
“The falls risk profile is completely different for those living in the community which means we need different approaches for different populations.”
Results on average:
- the cost of an injurious fall per incident was $2,494
- the average cost of falls per resident per year was $1,798
- the potential cost of injurious falls per annum in Australia’s residential aged care system was $325 million
- gender and body mass index were identified factors associated with fall injury.
Despite a national prevention strategy through the Australian and New Zealand Falls Prevention Society already in place, more is required to design a strategy exclusively catering to aged care residents, says Okafor.
“Falls in this setting cannot be absolutely prevented but can be minimised,” he tells AAA.
“First, the challenges providers experience in the delivery of service needs to be uncovered with the relevant stakeholders to address the needs of the sector. Regular training of aged care staff is also relevant. Tailored care delivery to aged care residents is also necessary, as the fall risk profile may vary across different aged care residents. Ensuring the providers are not understaffed will encourage tailored care delivery.”
I would like to see a tailored management approach, which considers the individuals risk profiles
Comans tells AAA providers can implement changes to prevent further injury and minimise financial costings associated with injury.
“Education of staff is key. Many staff are not aware of the multi-factorial nature of falls (a combination of factors internal to the person and the external environment) or even that falls can be prevented. Staff need to be able to anticipate people’s needs so that they can respond,” she says.
“For example, preventable falls happen when people can’t get to the toilet on time because they can’t get a staff member to help them. Or they try and get up themselves when they need assistance. Falls are also more likely with certain medications, so staff need to be aware of what residents are taking and what time of day they are most likely to be affected. Vision impacts people as they may not see a change in surface or level and vestibular changes can cause dizziness and loss of balance. Just making sure people have the right glasses can help.”
When the new Aged Care Act comes into force on 1 July this year, Okafor says he wants improvements in the management of fall risk in residential settings.
“I would like to see a tailored management approach, which considers the individuals risk profiles,” he says.
Professor Comans is also hoping for change to arrive in July.
“I’d like to see more emphasis on programs to improve residents’ strength and balance through access to allied health services,” she says. “And specific education programs for staff who do the majority of the caring.”
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