20:- Summary of falls epidemiology based on various sources. Document section Reference Time period Data source Age group Numbers of falls Geography Comment 2 Background Gribben et al (2009) ?? GP data 60+ 475,000 per UK This figure appears to be a gross under estimate ONS (2009) 2008 Deaths ?? 3,400 pa England and Wales Suggestion is that mortality data under estimate true mortality associated with falls. See Lyons et al (2005) below. Scuffman (2003) 1999 A and E attendances 60+ years 647,721 pa UK Data now over 12 years old, figures would be expected to be substantially higher IP admissions 60+ years 204,424 pa UK 4.2 Incidence of falls Our estimates (see section for references) 2010 Population falls 60+ 230,000 to 460,000 Wales 2010 Population injury (fracture, head injury, serious laceration) 60+ 11,500 to 45,900 Wales 4.3 Fall related mortality Stats Wales deaths All ages Approx 200 pa Wales Probably in line with ONS data, but based on Lyons et al (2005) gross underestimate Lyons et al (2005) Hip fracture deaths 10,800 pa expected England and Wales 4.4 burden PEDW 2005/06 to 2008/09 Falls admissions All ages Average 21,000 pa Wales Assuming increases in Scuffman (2003) over time, figures appear to be in right area. Plus fit with epidemiological estimates of injury falls (section 3.2) Falls FCEs 60+ years Average 15,260 pa Wales 4.5 ED burden ED data 2009/10 attendances 60+ years 12,600 Wales Appears to be a considerable underestimate, especially when compared with Scuffman (2003) above
Epidemiological conclusions Falls are a common and serious problem, particularly amongst older people. They place a significant burden on health and health services, and serious fall injuries, such as hip fracture, reduce quality of life dramatically. Based on the population structure, it is estimated that between 230,000 and 460,000 over 60 year olds fall in each year. Between 11,500 and 45,900 of these suffer serious injury. With predicted increases in the aging population, this will rise to between 12,400 and 49,400 by 2015. The biggest impact will be in Powys, which has the largest proportion of the population aged over 60. There are around 200 fall related deaths in each year and deaths increase with increasing age. Injury accounts for around 2.8% of all hospital admissions, with general falls accounting for around one third of these. There has been no change in numbers of fall related admissions over recent years. The majority of finished consultant episodes (FCEs) for falls are for women and over 60 year olds account for around 65% of fall FCEs. Lengths of stay following a fall are considerably longer than for other conditions; up to 6 day difference in the median in some cases. Based only upon bed days, it can be estimated that falls cost £89M per year in . Prevention will have some impact on the overall in-patient burden, but the obvious priority should be to reduce lengths of stay following a falls admission. Reduction in numbers of falls that result in injury and require admission is also important, but will have less of an impact on secondary care. There is a suggestion that targeting the most deprived should be a priority, but given the burden of falls, a universal approach is likely to be most useful and beneficial. The emergency department burden is difficult to quantify and the data presented here are likely to underestimate the problem. However, the burden will increase in the future with increases in the aging population.
Prince Charles Hospital No No, not at all No No No policy No No Yes No Yes Royal Glamorgan Hospital No No Provides time No No, not at all No No Yes No No No No No No RCT / Merthyr Tydfil LHB No No Yes No Yes No Yes No Yes, fully Yes Yes No Yes Yes Yes Yes No A&E or MAU Denbigh and LHB Yes No Yes Yes No Flintshire LHB Yes No Yes No Yes, partially Yes No No No No No, not at all No No No No A&E or MAU No Gwynedd LHB No No Yes No Yes, partially No No No, not at all No No No policy No No No No No Bronglais No No No No Yes, partially Yes Yes No No No Yes No No Yes No No Prince Philip No Yes, partially No Yes No No No Yes No No No No Yes No West Wales General No No, not at all No No No Yes No No No No No Withybush No No No Yes Yes, partially No Yes No No No policy Yes No Yes No No North East Wales NHS Trust No Yes Yes No Yes, partially Yes No Yes No No policy Yes No No Yes Yes Yes North Wales (Central) NHS Trust No Yes Yes Yes No, not at all No Yes Yes Yes No No No No North West Wales NHS Trust No Yes Yes Yes Yes, fully Yes No Yes Yes Yes Yes No No No No Yes Yes Powys LHB No No No No Yes No No Provides time No Yes, fully Yes Yes No No Yes Yes Yes No No Yes Yes