Fall-related Hospitalization Incidence and Related Injuries among Older Adults in Texas

Background:
With the rapid growth of the aging US population, the incidence of falls and fall-related injuries are expected to rise. This study examines factors associated with the overall incidence and likelihood of fall-related hospitalizations (falls), among Texans aged 50 and older. We were especially interested in the geographic distribution of falls.

Methods:
Cross-sectional analyses of fall-related hospitalization were performed using the 2011 Texas Hospital Inpatient Discharge Public Use Data File. Descriptive statistics were utilized to examine hospital discharges. Logistic regression analyses were conducted to model the occurrence of reported falls.

Results:
Of the 2,937,579 recorded hospital discharges, there were 60,404 falls among adults aged 50 and older, of which 66.8% were females, 61.9% aged 75 and older, and 14.8% rural residents. Bivariate factors associated with a greater likelihood of a fall included being older, being female, being White (versus Asian or Black), and residing in rural areas. In adjusted analysis, factors significantly associated with a greater likelihood of a fall included being age 65-84 (OR=2.0) or age 85+ (OR=4.4) versus age 50-64, being female (OR=1.5), being White (versus Black, OR=2.1 versus Asian, OR=1.1), and residing in an urban area (OR=1.2).

Conclusions:
The likelihood of having a fall-related hospitalization varies by age, sex, race and geographic setting. Findings indicate the need for increased efforts to identify older adults at elevated risk for falling and develop referral systems for promoting evidence-based fall prevention programs at multiple levels (e.g., evidence-based community programs or clinical interventions) that account for geographical settings.