June 8, 2015
Comprehensive prevention program effectively reduces falls among older people
Families and physicians have a new tool in the fight against falls- a comprehensive prevention program developed by the U.S. Department of Health and Human Services that reduces both falls and resulting use of long-term care such as nursing homes.
The prevention program, which includes clinical in-home assessments of health, physical functioning, falls history, home environment, and medications to create customized recommendations, was developed by HHS based on the research evidence on risk factors and interventions. Using a randomized control trial, the program was tested among long-term care insurance policy holders age 75 and older to determine whether the intervention was effective and, if so, the impact on long-term care utilization.
The study found that the program led to significantly lower rates of falls over a one-year study period. Those who received the intervention had a 13 percent lower rate of falls, and an 11 percent reduction in risk of falling compared to the control group. Participants also had a significantly lower rate of injurious falls. Long-term care insurance claims were 33 percent lower over a three-year period. The intervention, which cost $500 per person to administer, saved $838 per person.
Falls- which happen to 1 in 3 people age 65 and over every year-- can cause pain, suffering, and death, and cost an estimated $35 billion in health care spending in 2014. They are a leading risk factor for needing long-term care at home or in a nursing facility. Given the impact of falls, findings from the HHS-funded study give hope for reducing the rate of falls among the growing population of older adults.
“While falls are preventable, we need to intervene at the right time in a way that is comprehensive and yet individually tailored,” said Richard Frank, Ph.D., the assistant secretary for planning and evaluation at HHS, whose office funded the study. “Preventing falls helps everyone: the older person, their family, and the health and long-term care systems. And this study shows that by investing in falls prevention, we can reduce long-term care use and spending.”
The risk factors for a fall include fear of falling, gait and balance problems, certain medications, clutter in the home, and some health conditions. Few interventions have taken a comprehensive approach to address all of the risk factors through one program.
Although this study focused on the rate of falls and long-term care utilization and costs, future research will examine the impact of the intervention on health care utilization and costs.
“We expect to see a similar or greater return on investment in terms of health care costs,” added Richard Frank.
The 2015 White House Conference on Aging, in partnership with the National Council on Aging, recently convened a Falls Prevention Summit to call attention to the critical role of falls prevention in healthy aging and to provide opportunities for older Americans and stakeholders to share their views and ideas on this important issue. More information about the intervention and the study design are available at http://aspe.hhs.gov/daltcp/reports/fallexpfr.htm.
The study appears online and in print in the June issue of Health Affairs.