Falls rate number one

By Yasmin Noone

Unintentional falls continue to be the leading cause of injuries requiring hospitalisation in Australia, according to a new report released by the Australian Institute of Health and Welfare (AIHW).

The report, Hospital separations due to injury and poisoning: Australia 2009-10, shows that there were about 420,000 injury cases requiring hospitalisation in Australia during 2009-10, an age-standardised rate of 1,858 cases per 100,000 people.

This is similar to the rate recorded in 2008-09 (1,865 cases per 100,000 people), but an increase on the rate in 1999-2000 (1,724 cases per 100,000 people).

“Of the 420,000 hospitalised injuries in 2009-10, 38 per cent of these were due to falls, the same proportion as in 2008-09,’ said AIHW spokesperson, Professor James Harrison.

Falls (32 per cent) were the leading cause of injury hospitalisations for adults aged 45-64, while 14 per cent were transport-related.

More than three-quarters (76 per cent) of injury hospitalisations for people aged 65 and over occurred as a result of a fall.

“Of all hospitalised injuries, 26 per cent occurred in the home.

“Females were more likely to be injured in the home, while males were more likely to have been injured on a street or highway.”

Rates of injury increased with geographical remoteness. The lowest rate of 1,728 cases per 100,000 population occurred in major cities in Australia, while the highest (3,857 cases per 100,000 population) occurred in very remote Australia.

More females, in total, were hospitalised due to falls than males (90,100 cases compared with 71,000 cases).

Falls expert from Neuroscience Research Australia (NeuRA), Associate Professor Jacqui Close, said the report highlights the impact that falls have on both older people and on health care resources.

“Much can be learnt from the report and many further questions should be asked,” A/Prof Close said.

“As states and territories invest in strategies to minimise falls, we should all be asking why rates are currently different across states.

“Where rates are lower in certain States (SA, Tasmania and WA), we should be asking what has been put in place over the years that might be contributing to these observed differences.

“Hip fracture is one of the most serious consequences of fall-related injury and frequently leads to loss of independence and can ultimately lead to institutionalisation and premature death.

“A recent report from Osteoporosis New Zealand highlights missed opportunities to prevent fall-related fractures.

“Approximately 50 per cent of hip fractures have previously sustained a low trauma fracture yet only a small percentage are offered interventions to minimise a future fracture event.”

The Australian and New Zealand Hip Fracture Group, based at NeuRA and supported by a number of key professional organisations and societies, is currently developing ANZ guidelines and standards for hip fracture care.

A registry is in the planning phase with the ultimate goal of using data to highlight variation in practice and drive change to improve outcomes for this high risk frail population.

The group is led by A/Prof Jacqueline Close and Prof Ian Harris, both who have clinical and academic expertise in this important area.

A website will be available by the end of 2012 and will host a number of resources designed to highlight the issue of fall-related injury, as well as collating evidence from the literature and identifying practical tools to prevent and manage falls and fractures.

More AIHW statistics

According to the new AIHW report, more than half of all hospitalised injury cases-around 242,500-involved men.

The second most common cause of hospitalised injury was transport accidents, accounting for 13 per cent of cases.

More than twice as many males as females were hospitalised for a transport injury (37,100 compared with 17,000).

The most common causes of injury hospitalisation for young adults aged 15-24 years were transport-related injuries (19 per cent), falls (14 per cent), assault (11 per cent) and intentional self-harm (10 per cent).

A similar pattern was seen in adults aged 25-44 years, where transport-related injury hospitalisation accounted for 17 per cent, falls 14 per cent and 11 per cent each for self-harm and assault.

The AIHW is a major national agency set up by the Australian Government to provide reliable, regular and relevant information and statistics on Australia’s health and welfare.