The incremental cost of falls among community dwelling older adults in Belgium

Background: Falls pose a considerable public health threat driven by population ageing and causing a substantial health burden among adults aged 65 and over. However, there is still limited evidence on the population-based costs caused by falls. Therefore, this study aimed to estimate the incremental healthcare cost of falls among older adults in Belgium.

Methods: Data from the Belgian health interview surveys (BHIS) and the Inter Mutualistic Agency (IMA) were used. The BHIS included a population-based sample of the Belgian population and provides information on health status, healthcare use, and societal factors. The IMA database contains demographic and socioeconomic characteristics as well as information on reimbursed healthcare services and medicines. The incremental cost of falls for community-dwelling older adults (65 years or older) was estimated at individual level using G-computation adjusting for confounders.

Findings: The weighted prevalence of falls (N=2,154; mean age=74·5y) in older adults was estimated at 16·6% [95%CI: 14·5%-18·7%]. There was a significant incremental cost in the year in which older adults fell and the year after of, respectively, €1,611 [€35; €3,415] and €2,026 [€81; 4,085]. Most costs were made in ambulatory health care.

Interpretation: With a significant incremental cost for older fallers in the first year of €1,611, falls count for nearly €575 million annually in Belgium. Increasing life expectancy and population growth underscore the importance of implementing effective fall‑prevention strategies to improve health outcomes and reduce healthcare expenditures.