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Reported increase in older adult fall deaths due to improved coding
Date:5/15/2012

The recent dramatic increase in the fall death rate in older Americans is likely the effect of improved reporting quality, according to a new report from the Johns Hopkins Center for Injury Research and Policy. The report finds the largest increase in the mortality rate occurred immediately following the 1999 introduction of an update to the International Classification of Diseases (ICD-10), suggesting a major change in the way deaths were classified. Several research studies, including one by the report's authors, found that rates of fatal falls among seniors had risen as much as 42 percent between 2000 and 2006. The results are published in the May-June issue of Public Health Reports.

"We had been perplexed by the sudden increase because neither the nonfatal fall rate nor the fall-hospitalization rate increased significantly," said Susan P. Baker, MPH, a professor with the Johns Hopkins Center for Injury Research and Policy, part of the Johns Hopkins Bloomberg School of Public Health. "By ruling out these variables, we found that a change in how the underlying cause of death gets reported explains much of the widely-reported increase."

As it turns out, the largest increase was seen in the coding subgroup "other falls on the same level," which refer to when an individual falls on the same surface they are standing or walking on; such falls generally do not result in injury that is immediately life-threatening.

"Death following a minor injury from a fall typically involves the elderly and usually occurs weeks or months after the fall as the result of pneumonia or other complications. Previously, many of these deaths were coded as the illness rather than the fall," said study author Guoqing Hu, PhD, faculty with the Central South University School of Public Health in China. "However after ICD-10 went into effect in 1999, the rate of deaths from this type of fall jumped, suggesting a major change in death certification practi
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Contact: Tim Parsons
tmparson@jhsph.edu
410-955-7619
Johns Hopkins University Bloomberg School of Public Health
Source:Eurekalert

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