Healthcare expenditure on older adult non-fatal falls by state.

Abstract

Objectives: Falls are a leading preventable cause of death and injury among older adults (65+). Healthcare spending in the USA on non-fatal falls was estimated at $80 billion in 2020. We aim to estimate healthcare spending on older adult non-fatal falls by state.

Methods: Healthcare spending for all adults was derived from the 2020 Centers for Medicare and Medicaid Services (CMS) Health Expenditures by State of Residence files. These data covered three payor types: Medicare, Medicaid and private health insurance (PHI). Using the national 2020 CMS Health Expenditure by Age Group files, the national proportion of healthcare spending for older adults was calculated for each payor type. These national proportions were applied to each state's healthcare spending data to estimate healthcare spending for older adults in each state, adjusted for the proportion of older adults in each state. To estimate the proportion of older adult healthcare spending attributed to non-fatal falls, these adjusted values were combined with the falls-attributable expenditure factors calculated in Haddad (2024). The final state-level estimates of healthcare spending on non-fatal older adult falls were calculated for each payer type: Medicare, Medicaid and PHI. All estimates were inflated to 2023 dollars.

Results: Overall state-level spending on non-fatal falls ranged between $112.7 million in Alaska to $8.3 billion in Florida. Per-capita spending estimates ranged between $1085 in Utah to $2262 in Wisconsin.

Conclusions: Measuring the cost of non-fatal falls at the state level can help inform regional differences and improve targeted fall prevention efforts.