The epidemiology and cost of falls requiring hospitalisation in children in Western Australia: a study using linked
Rachael E Moorin1, Delia Hendrie
1Australian Centre for Economic Research on Health, School of Population Health, The University of Western Australia, 35 Stirling Highway, Crawley, WA 6009, Australia. rachael.moorin@uwa.edu.au
Insights
Children's falls in Western Australia cost the health system A$21.5 million in 2003. Males, Aboriginal children, and those aged 5-9 years, particularly from playground falls, incurred the highest costs.
Area of Science:
- Public Health
- Epidemiology
- Health Economics
Background:
- Children's falls represent a significant public health concern.
- Understanding the epidemiology and economic impact of pediatric falls is crucial for targeted prevention strategies.
Purpose of the Study:
- To investigate the epidemiology and health system costs associated with children's falls leading to hospitalization in Western Australia in 2003.
- To identify high-risk groups and injury mechanisms contributing to the burden of pediatric falls.
Main Methods:
- Utilized the Injury Cost Database to identify hospitalized pediatric fall cases.
- Employed Poisson regression to model adjusted incidence rate ratios (IRR) for hospitalizations.
- Assigned in-patient costs using DRG data and extrapolated to total health system costs.
Main Results:
- Males exhibited a 53% higher incidence of falls requiring hospitalization compared to females.
- Aboriginal children had a 36% higher incidence than non-Aboriginal children; incidence decreased with age.
- Total health system cost was estimated at A$21.5 million, with community costs at A$108.5 million. Falls on the flat were costly for younger/older children, while playground falls were most costly for 5-9 year olds.
Conclusions:
- Pediatric falls impose a substantial economic burden on the healthcare system and the community.
- Risk and cost burdens are concentrated among males, Aboriginal children, and 5-9 year olds, with playground falls being a key factor for this age group.
Objective:
The aim of this study was to examine the epidemiology and health system cost of children's falls resulting in hospitalisation in 2003 in Western Australia.
Methods:
The Injury Cost Database was used to identify children who were admitted to hospital with a falls related injury. Adjusted incidence rate ratios (IRR) of hospitalisation were modelled using Poisson regression. In-patient hospital costs were assigned using the published DRG costs for Western Australia. These costs were then extrapolated to health system costs based on previously published relative proportions.
Results:
When adjusted for other covariates in the model males had a 53% higher incidence of falls requiring hospitalisation compared with females. Aboriginal children had a 36% higher incidence compared with their non-Aboriginal counterparts, and the incidence of falls reduced with increasing age. The total cost of in-patient hospitalisation associated with children's falls in Western Australia was A$4,554,000 with an average cost of A$1876 per case. In children aged 0-4 years and 10-14 years the highest cost resulted from falls on the flat (slips and trips). However, in children aged 5-9 years injuries resulting from falls from playground equipment resulted in both the highest cost group (A$539,000) and the highest cost per case (A$1917). The total cost to the health system of children's falls in Western Australia in 2003 were estimated to be A$21.5 million, with the total cost to the community estimated at A$108.5 million.
Conclusion:
Children's falls impose a considerable burden and cost to both the health care system and the community. This study has provided information on where the burden of risk and the majority of costs lie, namely males, Aboriginal children and for children aged 5-9 years, unlike their younger and older peers, playground equipment.
