Dataset Information

Predicting Falls in People Aged 65 Years and Older from Insurance Claims.

ABSTRACT: BACKGROUND:Accidental falls among people aged 65 years and older caused approximately 2,700,000 injuries, 27,000 deaths, and cost more than 34 billion dollars in the US annually in recent years. Here, we derive and validate a predictive model for falls based on a retrospective cohort of those 65 years and older. METHODS:Insurance claims from a 1-year observational period were used to predict a fall-related claim in the following 2 years. The predictive model takes into account a person's age, sex, prescriptions, and diagnoses. Through random assignment, half of the people had their claims used to derive the model, while the remaining people had their claims used to validate the model. RESULTS:Of 120,881 individuals with Aetna health insurance coverage, 12,431 (10.3%) members fell. During validation, people were risk stratified across 20 levels, where those in the highest risk stratum had 10.5 times the risk as those in the lowest stratum (33.1% vs 3.1%). CONCLUSIONS:Using only insurance claims, individuals in this large cohort at high risk of falls could be readily identified up to 2 years in advance. Although external validation is needed, the findings support the use of the model to better target interventions.

SUBMITTER: Homer ML

PROVIDER: S-EPMC5441951 | biostudies-literature | 2017 Jun

REPOSITORIES: biostudies-literature

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Predicting Falls in People Aged 65 Years and Older from Insurance Claims.

Homer Mark L ML Palmer Nathan P NP Fox Kathe P KP Armstrong Joanne J Mandl Kenneth D KD

The American journal of medicine 20170120 6

<h4>Background</h4>Accidental falls among people aged 65 years and older caused approximately 2,700,000 injuries, 27,000 deaths, and cost more than 34 billion dollars in the US annually in recent years. Here, we derive and validate a predictive model for falls based on a retrospective cohort of those 65 years and older.<h4>Methods</h4>Insurance claims from a 1-year observational period were used to predict a fall-related claim in the following 2 years. The predictive model takes into account a p ...[more]

PMID: 28111165

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Project description:BackgroundExercise prevents falls in older adults. Regular updates of estimated effects of exercise on falls are warranted given the number of new trials, the increasing number of older people globally and the major consequences of falls and fall-related injuries.MethodsThis update of a 2019 Cochrane Review was undertaken to inform the World Health Organization guidelines on physical activity and sedentary behaviour. Searches were conducted in six databases. We included randomised controlled trials evaluating effects of any form of physical activity as a single intervention on falls in people aged 60+ years living in the community. Analyses explored dose-response relationships. The certainty of the evidence was assessed using Grading of Recommendations Assessment, Development and Evaluation (GRADE).ResultsThis review included 116 studies, involving 25,160 participants; nine new studies since the 2019 Cochrane Review. Exercise reduces the rate of falls by 23% (pooled rate ratio (RaR) 0.77, 95% confidence interval (CI) 0.71 to 0.83, 64 studies, high certainty evidence). Subgroup analysis showed variation in effects of different types of exercise (p < 0.01). Rate of falls compared with control is reduced by 24% from balance and functional exercises (RaR 0.76, 95% CI 0.70 to 0.82, 39 studies, high certainty evidence), 28% from programs involving multiple types of exercise (commonly balance and functional exercises plus resistance exercises, RaR 0.72, 95% CI 0.56 to 0.93, 15 studies, moderate certainty evidence) and 23% from Tai Chi (RaR 0.77, 95% CI 0.61 to 0.97, 9 studies, moderate certainty evidence). The effects of programs that primarily involve resistance training, dance or walking remain uncertain. Interventions with a total weekly dose of 3+ h that included balance and functional exercises were particularly effective with a 42% reduction in rate of falls compared to control (Incidence Rate Ratio (IRR) 0.58, 95% CI 0.45 to 0.76). Subgroup analyses showed no evidence of a difference in the effect on falls on the basis of participant age over 75 years, risk of falls as a trial inclusion criterion, individual versus group exercise, or whether a health professional delivered the intervention.ConclusionsGiven the strength of this evidence, effective exercise programs should now be implemented at scale.

Dataset Information

Predicting Falls in People Aged 65 Years and Older from Insurance Claims.

Publications

Predicting Falls in People Aged 65 Years and Older from Insurance Claims.

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