Health Service Planning: Analysis of Fall Injuries in Older Adults

This report analyzes the significant issue of fall injuries among adults over 65, highlighting the increasing prevalence, associated costs, and impact on quality of life. It examines the causes of falls, including occupation, substance use, medical conditions, socioeconomic factors, and environmental hazards. The report details the severe consequences of falls, such as disabilities, reduced income, economic burdens, and fatalities. It further explores the risks of inaction, projecting rising costs and a decline in the quality of life for older adults. The report presents scenario models to explain fall injury, considering risk factors and determinants like aging, and proposes changes for improved outcomes, focusing on policy interventions, awareness campaigns, and effective medical interventions. The report concludes with recommendations for fall prevention strategies and emphasizes the importance of comprehensive healthcare planning to address this critical public health concern, supported by data and projections. The report also includes a cost projection graph and discusses other relevant graphs as required by the assignment brief.

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Table of Contents
Introduction................................................................................................................................................2
The situation...............................................................................................................................................2
The impact of injury due to fall..................................................................................................................5
Risk of not solving the fall injury................................................................................................................5
Scenarios models........................................................................................................................................7
Changes that will impact the outcome.....................................................................................................10
Benefits of implementing changes...........................................................................................................12
Rebuttal.....................................................................................................................................................12
Recommendations....................................................................................................................................13
Reference..................................................................................................................................................14

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Introduction
Injury of one of the most common health phenomena that cost taxpayers a lot of money
to treat and care for those people with injuries. Fall is attributed to most cases of injuries among
older adult people of age over 65 years. The issues are attributed to high cost, poor quality of life
and even death. Planning for future prevention of the phenomenon is not only beneficial to the
health sector but also influence the quality of life among older people. The following paper
presents health planning aiming at analysis of the situation, implication, and future prevention
strategies.
1.ISSUE
An injury that is attributed to a fall in people of over 65 years of age has been a health
concern that keeps on increasing with data and cost. According to the World Health Organization
(WHO) (2018), fall is the second leading cause of accidental injury that causes death. The value
is worst in many low and middle-income countries which contribute to over 80% death resulting
from fall. This is translated to an estimated 646 000 people that die from fall globally each year.
Of this figure the adult people of age over 65 accounts for the greatest percentage of these fatal
falls. Also, the number of falls each year is estimated to approximately 37.3 million which is a
high number that needs medical attention. Studies show that over 60% of the deaths attributed to
fall injuries are from western pacific and southeast pacific (Gale, Cooper & Aihie 2016).
2.BACKGROUND
Some other challenges are also linked or attributed to falling injuries. Some of these
include disability, fatal and hospitalization and subsequent cost. Injuries that result from fall are
sometimes fatal leading to the death of people involved. Some fall leads to an injury that makes

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the victim disable for life and this makes reduction economic productivity of the victim.
Moreover, fall injuries in most cases lead to hospitalization of the victim for some days or
months. This is costly and worst for adult people of age over 65 years. The figure is nearly over
17 million disability-adjusted life years (DALY) with older adult people leading in morbidity.
40% of victims are children and the DALY is more in children due to more life years to lose
(Ballestas, Xiao, McEvoy & Somerford 2011).
Figure 1: Population Projections
Injury attributed to falling has huge financial implications that call for a serious action to
rectify the situation. The Republic of Finland and Australia for instance reports cost
hospitalization per fall as US$ 3611 and US$ 1049 respectively. The cost also varies due to the
severity of the fall case based on the health condition of the victim. The cost of treatment

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especially when the victim has suffered from disability has been shown to effects the economic
productivity of the victim and their families. The cost is further transferred to the government
that normally supports most of the health care services (Bradley 2013b).
Fall injuries are caused by several factors occurring in the life of victims. Firstly,
occupation may place a hazard in the life of older people leading to falling. Secondly, alcohol or
substance use poses risk to the life of victims especially older people. Thirdly, medical
conditions such as neurological and other medical disabling conditions that affect people leading
to falling. Fourthly, socio-economic factors that may lead to stressful conditions posing risk in
the life of those affected. Lastly, environmental factors that may affect people that have some
health challenges such as poor vision or poor mobility (Bradley 2013).
2.1 The impact of injury due to fall
The impact of injury due to fall has been great with many victims or families suffering
from several issues. Firstly, fall has resulted in a high number of disabilities that make victims
suffer for life. The number of people that end up in wheelchairs due to fall injury keeps on
increasing every year. The impact of fall in the life of the victim has left many disable and
suffers for the remaining part of their life. Secondly, the reduced income due to loss of
employment or long-time hospitalization is another impact of fall injury (Hu & Baker 2010).
This is common among the middle age people that end up being hospitalized for a long time
leading to loss of employment of low income. Besides, fall injury may decrease the ability of the
victim to work leading to total dependence on other family members. Thirdly, the economic
impact of fall has been great with the worst situation common among older people. The cost of

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treatment or cost of hospitalization remains a worry among families that are affected. Besides,
older adult people of age over 65 years take time to recover leading to more spending in
treatment. Lastly, fatal fall has left many families in agony as their loved ones succumb due to
falling injury. This is also translated to economic impact as victims may have been a source of
finance and death result in poor living conditions (Australian Bureau of Statistics 2013).
2.2 Risk of not solving the fall injury
Some risks are associated with not solving the issue of fall injury among the older adult
people of over 65 years. Firstly, there is an increasing trend that is projected to continue if the
problem is not solved as shown in figure 2 below. This means that the amout allocated to the
healht service department will increase with time if the fall issue is not resolved. The data show a
worrying trend that continues to attract more actions as countries such as the US reporting more
than 3 million emergencies resulting from accidental fall injuries (Maresh, Guse & Layde 2012).
There is estimated to be approximately one in every four older adults of over 65 years of age
experience fall. The Australian case put fall as accounting for over 30% among adult per year
and the data is on the increasing trend due to the aging population. Also, the number of older
people in Australia of over 65 years was 14% in 2010 accounting for 3 million people and is
projected to increase to 23% representing 8.1 million people by 2050. This implies that the
estimated cost will also increase to approximately $1.4 billion by 2051. For instance, in NSW
alone the figure was estimated to be 1.27 million people in 2017 and expected to increase to 2.27
million by 2051. This when translated into treatment cost account for a figure of $321 million in

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2017 and $482 million in 2051 (Aged Care Research & Evaluation Unit 2014).
Figure 2: Cost projection
Secondly, the financial implication of fall injury is continuing to baffle Australia health
sector. The cost of treatment of fall injuries or related health issues shows a worrying trend in
Australia and globally. By 2010 the number of beds occupancy per year related to fall injury was
240000 and is projected to reach 450000 by 2051 (Pointer2015). This means the number of bed
occupancy due to falling related injuries will double in Australia by 2051. Moreover, nursing
homes utilization which has also experienced an increasing trend is also expected to increase
800000 beds in 2010 to over 1.8million beds in 2051. The Australian health sector estimate that
hospital admission due to fall-related injury among over 40 years of age keeps on increasing by
4.5% annually for men alone. Women, on the other hand, are 7.9% per year and the percentage
increase by progressive age increase (Hendrie et al., 2016).
Thirdly, quality of life reduces among older adult people if the fall issue is not resolved.
Many older adults report fear from fall and lack of independence for risk of fall and this leads to

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poor quality of life among this age group. This fear arises from fall-related injuries or post-fall
syndrome that incites fear among older people. Also, the reduction of mobility and independence
is attributed to the post-fall syndrome. Nearly, over 48% older people in Australia fear falling
and more than 25% of these with fall fear has reduced their activities for fear of fall. Those older
people that have been through fall-related injuries and hospitalization have disabilities that make
the quality of their life poor (Bloch et al., 2011).
2.3 Scenarios models
Some fall scenario models have been used to explain the fall injury phenomenon. Firstly,
the fall injury issue occurs due to the interaction of many different risk factors that include
biological, behavioral, socioeconomic and environmental risks. The model description that is
shown in the figure below identifies the bulging areas of the graph that is mostly within the 65-
age bracket. The trend continues with an increase in population between 2005 and 2025 which is
10 years.WHO therefore puts it as key factors in the fall study as can be deduced from the graph.
Another scenario also places the increasing trend between 2004 to 2035 and the trend is similar
to an increasing number of victims (Ambrose, Paul &Hausdorff 2013).

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Figure 3: Risk Factors Model
Secondly, another scenario model attempts to explain the fall from the determinants
viewpoint and this takes into consideration aging as the main determinant of fall pheromone. The
determinants of fall as explained through this model show that access to health service,
behavioral, environment, and personal factors interact with the aging factors to determine the
risk of falling among the older people. Besides active ageing model as shown in the figure below
indicates the possibility of fall due to various determinants interactions.

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Figure 4: Determinants of fall
Improving the determinants is likely to reduce the fall risks among the vulnerable
population as shown in the figure (Bansal, Hirdes, Maxwell, Papaioannou & Giangregorio 2016).

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Figure 5: Functional Capacity
2.4 Changes that will impact the outcome
Some changes should be implemented to ensure there are improved outcomes. According
to WHO, preventing fall and fall-related injury requires three main prevention models. Firstly, an
effective policy intervention and risk identification model is an important outcome improvement
model. The development of policy that addresses the increasing trend of fall is an important step
when dealing with fall risk. Educating the older people on the risk of falling and fall preventing
is one example of a fall prevention strategy. Government being the responsible agent for
protecting the life of older people needs to come up with policies that assess all areas to ensure

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that fall is prevented at all cost. Moreover, the government needs to allocate funds that are
directed towards fall prevention strategies (Pearson, St-Arnaud & Geran 2014).
Secondly, building awareness and environmental screening model for fall prevention
among the vulnerable population is a fall prevention model. The model takes into consideration
two main sections that include creating awareness of fall prevention and screening for
environmental risk. Community, caregivers, and family of older people need to know the
importance of preventing fall risks and possible ways to prevent fall risks. Screening for
environmental risk is an important change that will ensure that the number of fall-related injuries
is reduced substantively. Screening for possible fall risks is another important strategy as most of
the fall is estimated to be preventable. There are many living environments where older people
live that pose more danger and risk for falling to these age cluster. There is a need to assess the
risk environments to reduce the possible fall attributed to unsafe living environments.
Thirdly, effective medical interventions to address fall risks or related risk factors are
another important fall prevention model. Addressing the medical risk factors among older people
may be attributed to personal risk factors such as impaired vision. Older people should be
assessed for personal medical risk that may be related to some internal health factors as this will
ensure that a good medication or modified environment is done (Stafford, Alswayan & Tenni
2011). Patients or clients that have experience fall in their life may have some personal risk
factors such as poor vision or poor mobility. This requires environmental modification to reduce
risk factors. For instance, treatment of low blood pressure, vitamin D and calcium supplement
are other medical interventions that may reduce the risk of falling among older people. For
effective medical care to prevent fall injury there is a need for more than 3320 residential aged

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care within Australia that will take care of older adult people (Australian Government
Department of Health and Ageing 2012).
2.5 Benefits of implementing changes
Implementing changes that help prevent fall among older people is attributed to some
benefits among the Australian citizens. Firstly, the reduction in the cost of treatment and
hospitalization of fall-related cases is an important benefit of preventing fall. The prevention of
fall-related risks and injuries among older people being vulnerable is projected to cause
substantively reduction in the cost of treatment that is a channel to injury each year. The
Australian government estimate that fall prevention is likely to help the government maintain the
health cost by reducing the fall incidence by 66% (Watson, Clapperton & Mitchell 2010).
Improved quality of life is another benefit that is attributed to falling prevention,
especially among older people. Fall prevention reduces risk of falling and risk of disability due to
fall injury. This is important for maintaining the health and quality of the life of older people
within Australia. Additionally, the quality of life is maintained when the older adult people can
move freely with independent without risk of falling (Garcia et al., 2015).
Spending much on prevention of fall injury has cost advantages as many related
treatments are reduced. A sucessful prevention of fall strategy will lead to redcued cost of
treatment, cost of hospitalization, and cost of mechanical mobility support. Prevention of fall
injuries help prevent funds allocation to other treatment cost which has been expensive for the
government and citizens afftected.

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3.Rebuttal
Despite the health benefits of fall prevention and interventions that reduce fall injuries,
the cost of caring for older people remain high within the country. The cost of implementing fall
prevention interventions within the community and health sector, in general, is high that equality
cost the taxpayers’ amount of money. Besides, money that would have been channeled to other
health treatment issues is directed towards facility modification to prevent fall among patients.
This is costly and more evaluation is still needed to assess the cost-benefit analysis. Comparison
between the cost of preventing fall injuries alongside treatment cost is important for establishing
the benefits of channeling of funds to these strategies (Korhonen et al., 2013).
4.RECOMMENDATIONS
The significance of fall injury is still great that point to some changes and implantation of
changes. Firstly, there is a need for fall prevention among older people being the most vulnerable
population affected by a fall phenomenon. The cost of treatment and caring for fall injuries is
high that point to the need for prevention. As indicated in the paper the number of bed occupied
each year due to fall injury will increase from 240000 to over 450000 by 2051. When translated
to cost, a figure from $321 to $482 in 2051 will be used in treatment for a fall injury. Therefore,
the cost of treatment necessitates the need for prevention. If the fall issue is not resolve the cost
will increase but if the government inplmentes the recommendations the cost will fall as
prevention strategy (Burton, Lewin & Boldy 2015).

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Figure 6: If fall is prevented
Secondly, the government needs to intensify home modification as house approval
strategy that ensures that before building are approved there is fall risk reduction systems. The
building that is most likely to be used by older people needs risk prevention structure before the
approval. This will ensure that the environment reduces the risk of falling among people (Burton,
Lewin & Boldy 2013).
Thridly, Creating fall prevention awareness and education is needed to prevent various
fall-related risks. there is need for fall prevention to decerase the cost of treating fall injuries. the
cost implications of fall injury is great and keep on increasing and failure to resolve the issue
more funds will have to be allocated. Families, the community and caregivers need to be trained
on the strategies for caring for older people to minimize fall. Training needs to create awareness
on the fall risks and prevention strategies as this will ensure that the number of falls is reduced.

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