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National Trend Data on Hospitalization of the Elderly for Injuries, 1979-2001. Margaret Jean Hall, Ph.D. Lois Fingerhut, M.A. Melissa Heinen, M.P.H. Study Objectives – to analyze trend data on elderly injury hospitalizations and to identify ways to decrease injuries in the future.

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national trend data on hospitalization of the elderly for injuries 1979 2001

National Trend Data on Hospitalization of the Elderly for Injuries, 1979-2001

Margaret Jean Hall, Ph.D.

Lois Fingerhut, M.A.

Melissa Heinen, M.P.H.

slide2

Study Objectives – to analyze trend data on elderly injury hospitalizations and to identify ways to decrease injuries in the future.

slide3

Data from the National Hospital Discharge Survey- Based on a sample of non-federal short-stay hospitals- Abstracted from the medical records of a sample of inpatients- Data for 1979-2001 for about 450 hospitals and 300,000 discharges per year- Weighted to produce national estimates

injury defined by international classification of disease codes icd 9 cm

Injury defined byInternational Classification of Disease Codes (ICD-9-CM)

800-909.2, 909.4, 909.9,

910-994.9, 995.5-995.59,

995.80-995.85

Definition developed by the State and Territorial Injury Prevention Directors’ Association (STIPDA)

trends in injury hospitalization by age
Trends in injury hospitalization by age

65 and over

45-64

15-44

< 15

1979

2001

Elderly injury hospitalization rates were higher and did not

decrease as much as rates for younger patients.

injury hospital patients under and over age 65
Injury hospital patients under and over age 65

%

The proportion of injury hospital patients who are elderly has

been increasing.

elderly injury hospitalization
Elderly injury hospitalization

19792001

# of discharges 593,000 717,000

Rate per 10,000

population 235.9 202.8

% of total elderly

hospitalizations 7% 6%

type of injury resulting in elderly hospitalization
Type of injury resulting in elderly hospitalization

Other injuries

Poisoning

Internal injuries

Fractures

Most of the elderly injury hospitalizations were for fractures.

The share of injury hospitalizations for fractures increased

over time.

injury hospital discharge rates by sex for those 65 and over
Injury hospital discharge rates by sex for those 65 and over

females

males

1979

2001

Elderly females had higher injury hospital discharge rates than elderly males.

fracture hospitalization rates by sex for the elderly
Fracture hospitalization rates by sex for the elderly

females

males

1979

2001

Elderly females have higher fracture hospitalization rates than males. Both male and

female fracture hospitalization rates for the elderly remained stable over time.

hip fracture hospital discharge rate for females 65 and over
Hip fracture hospital discharge rate for females 65 and over

85 and over

75-84

65-74

2001

1979

Females 85 and over had the highest discharge rate for hip fractures and this

rate increased over time.

elderly injury patients with and without external cause codes
Elderly injury patients with and without external cause codes

Percent

No external cause

code

35%

51%

73%

90%

With at least one external cause code

External cause coding increasing but still missing for more than

a third of the elderly injury patients.

hospitalized elderly injury patients with no external cause codes 2001
Hospitalized elderly injury patients with no external cause codes, 2001

Had no room on abstract form for E-code

Had room for

E-codes on

abstract form

45%

55%

external cause of injury data for elderly injury hospitalizations 2001
External cause of injury data for elderly injury hospitalizations, 2001

No external cause

35%

Falls

49%

Other external causes

11%

3%

2%

Motor vehicle traffic

Poisoning

Falls were cause of almost half of elderly injury hospitalizations.

external cause of injury data for fracture hospitalizations for the elderly 2001
External cause of injury data for fracture hospitalizations for the elderly, 2001

No external cause

35%

Falls

55%

Other external causes

8%

Motor vehicle traffic 2%

Falls were cause of more than half of elderly fracture hospitalizations.

reasons why elderly are at higher risk of injury hospitalization

Reasons why elderly are at higher risk of injury hospitalization

Longer lives may bring more frailty or cognitive impairment

Illness or medications can cause dizziness

or unsteadiness

Slower response times, including while driving, can increase accident risk

Safety hazards often exist in homes

When elderly are in an accident there is a greater likelihood of being seriously hurt

what can be done

What can be done?

Complete health assessment and coordinated medical care, including vision checks, on a regular basis

Medication monitoring including dosage, side effects and drug interactions

Screening for osteoporosis in middle age to halt or even reverse bone damage

Weight-training and other exercise programs, such as tai chi, to keep older adults stronger and improve their gait

Improve the appearance and comfort of hip pads to prevent injury from falls, and identify ways to increase compliance with their use

what can be done18

What can be done?

Increase home safety by improving lighting, installing handrails on steps and in bathtubs, and eliminating other dangerous situations

Transportation

Conduct safe driver programs geared to the elderly

Teach physicians and family members how to assess whether an elderly person should continue to drive

Offer alternative forms of transportation for the elderly who don’t drive

slide19

Source of additional injury data:Trends in Injury Hospitalizations: United States, 1979-2001published byThe National Center for Health Statistics, CDChttp://www.cdc.gov/nchs/injury.htm