Fall prevention indicator priorities for public health and across health sectors in Ontario: a comparative study

Falls are the leading cause of injury-related emergency department (ED) visits and hospital admissions among older adults across many provinces in Canada. To effectively address this burden requires relevant data and indicators to inform fall prevention planning and evaluation for practitioners across the spectrum of prevention.

We used a modified Delphi approach, including an environmental scan, survey and pairwise comparison exercise to identify, refine and prioritize older adult fall prevention indicators across multiple health sectors in Ontario and specifically for public health. Three iterative phases of consultation were conducted with practitioners, as well as experts in injury prevention indicator development.

The prioritization exercise resulted in differing priorities between multiple sectors and public health. The highest ranked indicator for multiple sectors was the rate of ED visits, and the lowest was disability-adjusted life years due to a fall. For public health, the rate of hospitalizations due to a fall was ranked first, with the rate of mortality due to a fall last. The remainder of the list differs considerably by group, with certain indicators ranked on one list, but not the other.

This work identified, refined and prioritized indicators for older adult fall prevention across health sectors and for public health in Ontario. While both groups shared some highly ranked indicators, their differing responsibilities in fall prevention are reflected in the contents and order of their respective priorities for indicators. Delineating the unique data needs of each group highlights the importance of having consistent and actionable data that informs prevention planning and evaluation.