Continuous Improvement and the Expansion of Quality ... - NCQA

T H E S TAT E o f H E A l T H C A R E Q U A l I T y 2 0 1 1 • H E D I S M E A S U R E S o f C A R E
fAll RISk MANAGEMENT
falls among older adults are a growing national concern because of the financial and societal
costs associated with falls and the expanding body of evidence that falls can be reduced. 1,2 The Fall
Risk Management measure assesses whether adults over 65 years of age who are at risk of falling
discussed their problem with their practitioner and received an appropriate intervention, if necessary.
• Among adults 65 and older, falls are the
leading cause of injury and death—each
year one in every three adults experiences
a fall. 2 falls are also the most common
cause of nonfatal injuries and hospital
admissions for trauma. 3 The chances of
falling and of being seriously injured in a
fall increase with age. 2,3
• Most falls result in fractures. 3,4
the Case for Improvement
• Direct medical costs of falls total more than
$19.3 billion—$349 million for fatal falls
and $19 billion for nonfatal fall injuries. 6,7
This translates to $26 billion in dollars. 7
Hospitalizations and visits to the emergency
department make up more than 80 percent
of the costs. 7
• In 2009, 2.2 million adults were treated
in emergency departments for nonfatal
fall injuries; more than 581,000 of these
patients were hospitalized. 5
105
• Many older adults who fall develop a fear
of falling that may cause them to limit
their activities, leading to reduced mobility
and loss of physical fitness, which in turn
increases their actual risk of falling. 3
HEdIs Measure definition
The two components of this survey measure
assess different facets of fall risk management.
• The percentage of Medicare adults 75
years of age and older, or adults 65–74
years of age with balance or walking
problems or a fall in the past 12 months,
who were seen by a practitioner in the
past 12 months and who discussed falls
or problems with balance or walking with
their current practitioner.
• The percentage of Medicare adults 65
years of age and older who had a fall or
had problems with balance or walking in
the past 12 months, who were seen by a
practitioner in the past 12 months and who
received fall risk intervention from their
current practitioner.
M E A S U R E S T A R G E T E D A T o l D E R A D U l T S