David C. Schwartz^{1, 2}, Patrick C. Hardigan^3,

Background: Falls among the elderly are expensive and debilitating. Falls among elders are now the leading cause of injury ED visits, the leading cause of injury hospitalizations, a leading cause of hospitalization readmissions, the leading cause of hospitalizations from nursing homes, and a major cause of nursing home admissions. But, they are preventable. Design and Methods:A representative random sample of Medicaid-eligible seniors was selected proportionately by geographic density (i.e., zip code) in Miami-Dade and Broward Counties. Subjects participated in informational workshops; non-invasive somatic fall risk factor analysis; HIPPA-compliant sharing of risk reports with their physicians; in-home environmental fall risk analysis; pre- and post-fall counseling; periodic telephone calls to the elders’ support network (including physicians) and periodic safetygrams for an average of 28 months. Using 1.3 billion claims from the Florida Medicaid Data Warehouse, the participant groups were compared with several control groups on 1.) hospitalizations for injurious falls; 2.) nursing home stays for fall-caused injuries and 3.) Medicaid savings as a proportion of program costs. The study was carried out in 2015. Results: The treatment groups had statistically significantly lower healthcare utilization due to injurious falls than did various control groups: hospitalizations were lower; nursing home stays were lower; independent audits showed a savings of $2.40 for every $1.00 invested. Conclusions: Multi-disciplinary, socio-medical fall prevention programs for community-resident elders can significantly reduce healthcare utilization due to injurious falls among dual eligible elders.

aging, falls, public health, prevention