Importance of reducing harm from falls

ACC’s 500 claims a day underline importance of>campaign focus on reducing harm from falls

The importance of the Health Quality & Safety Commission’s Open for better care national patient safety campaign focus on reducing harm from falls in older people is underlined by figures that show the Accident Compensation Corporation (ACC) accepting more than 500 falls-related claims a day from people aged 50 and over.

Nearly 190,000 people in the 50-plus age group had an ACC falls claim accepted in 2013, 20,000 more than in 2011.

The figures from ACC are recorded in a new falls domain of the Commission’s Atlas of Healthcare Variation – a series of easy-to-use maps, graphs, tables and commentaries to highlight differences in the provision and use of specific health services and outcomes.

The domain has been released for this year’s April Falls awareness month and the start of Open’s latest six-month focus, ‘Stand up to Falls’.

It shows data relating to falls by people aged 50 and over by district health board (DHB) geographical area. The data is based on people with one or more accepted ACC claim in 2013, as well as on falls-related hospital admissions and hip fracture rates from the same year.

ACC claims varied 1.5 fold between DHBs.

There were:

• 92,301 claims from people aged 50–64

• 44,140 claims from people aged 65–74

• 33,142 claims from people aged 75–84

• 20,103 claims from people aged 85 and over

The claims from people aged 85 and over amounted to 55 a day and represented a quarter of people in that age group.

People aged 85 and over were twice as likely to have an ACC claim for a fall as those aged 50 to 64 – and 15 times more likely to be admitted to hospital as a result. Their average length of stay was 14.3 days.

Although those aged 85 and over make up 5 percent of the 50-plus age group, they accounted for nearly half of hip fractures relating to a fall.

‘The data in the atlas, particularly where it shows significant variation, will be of great use to DHBs,’ says Dr Shankar Sankaran, a consultant geriatrician at Counties Manukau Health and chair of the Commission’s falls atlas and reducing harm from falls expert advisory groups.

‘This information illustrates the need for DHBs to look at how well they are connecting across primary and community care, so falls initiatives are well integrated and encompass issues of frailty, fragility and fracture in vulnerable population groups.

‘It underlines the need for the Open campaign’s renewed focus on reducing harm from falls. Older New Zealanders, and especially those aged 85 and over, are particularly vulnerable to falls. Over the next six months, we have activities, along with new and existing resources, to raise awareness and to help both consumers and health professionals learn more about steps to take so our older people can stay safe and independent.’

The Open falls focus, in partnership with First, Do No Harm in the northern region, is based on strong evidence that falls in older people can be prevented.

Among Commission resources for older people and their family/whānau are the videos Staying safe on your feet at home and Staying safe on your feet in the community: www.hqsc.govt.nz/our-programmes/reducing-harm-from-falls/publications-and-resources/videos.

Key resources for health professionals and those working in aged care include pocket cards that suggest ways to Ask, Assess, Act to identify those at risk and provide advice on addressing the risk identified: www.hqsc.govt.nz/our-programmes/reducing-harm-from-falls/projects/ask-assess-act.

Depending on the individual older person’s risk factors, the recommended integrated care approach that follows might include a combination of targeted balance and strength exercises, home modifications to remove hazards, and possibly Vitamin D supplements.

Visit www.hqsc.govt.nz/atlas/falls to see the falls domain of the Atlas of Healthcare Variation in more detail and www.hqsc.govt.nz/our-programmes/reducing-harm-from-falls for more about Reducing Harm from Falls.

Visit www.acc.co.nz/olderfalls for ACC falls resources.

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