The Kings Fund has just produced a detailed analysis of the total health & social care costs for older people admitted to hospital following a fall in Torbay over a 12 month period. This should be of serious interest to anyone writing business cases for falls-related technology or generally doing any financial calculations in that area. (Torbay has excellent integration of patient/service user records that enables this analysis to be done with great accuracy).
The headline finding is that the total health and social care costs of dealing with older people who have had a fall that they have had to go to hospital for, in the year after that fall, is almost four times the immediate cost of the unplanned hospitalisation after the fall. Unsurprisingly, for those who die within a year of the fall, total costs are somewhat higher than for those who survive. Using the Kings Fund’s figures I calculate that the incremental health & social care cost of a fall is just under £7,000 (which includes both the immediate hospitalisation cost and the following years’ costs, less the previous year’s costs). This of course ignores the costs to the individual, their family and community.
Many readers will by now doubtless be wondering whether the costs of falling were reduced for those fallers who were Torbay Lifeline users as conventional wisdom is that the cost is very dependent on the length of time someone remains on the ground before being rescued. Sad to report that analysis was not done (see comments on the paper – I have requested it). Nevertheless it is a brilliant resource for anyone looking for cost information on this very important topic.
Hi Charles, if, as you say, they had released figures related to the amount of time spent in a “fallen state” it would give a bigger incentive to push for every social alarm to be deliver with the Auto Call wrist worn trigger and fall sensor from Telecom Design, with a proven track record of 3 years in production.
“Your first fall could be your last, don’t wait to be assessed for your risk of falling”
If the Kings Fund could prove that the deterioration of health (in a fallen state) can be reduced and does have a beneficial effect on the expensive “12 months after core event” figures then the resistance from the service providers would have to melt away…
One step at a time Tim!
First, we need to disaggregate the data so that we can look only at those people who are living independently in the community at the time of their fall. Figure 2 clearly shows high social care costs before the fall. Only then can we ask:
1. Does having a social alarm system have an impact? (although it might be reasonable to look at the local provider, don’t forget that older people in Torbay will also be targeted by national providers who offer a button and a box)?
2. Does having equipment that is more sophisticated than a button and a box mean that fallers are detected more quickly and reliably? (as Tim, and other telecare equipment providers, would claim) and
3. Does having access to a dedicated telecare emergency response team also improve outcomes?
I believe that we need to have the answers to these questions to prove the outcome benefits case for telecare, but to do so there is a need for much better profiling of service users, and in a manner that allows data to be shared with GP electronic records (which everyone has) and social care records (which only some people have). Only then can the benefits of Big Data be realised and appropriate interventions planned on the basis of risks and needs. This would provide the justification for more sophisticated assessment and prescription of telecare by appropriately trained staff – but whether this would convince vulnerable people that they need to use telecare is another matter. Don’t forget that the same people are prescribed medication by their GPs but often choose not to follow their advice. Convincing people to adopt telecare is about winning hearts and minds, and needs a concerted industry-wide campaign to promote these solutions.