Population Health and Strategic Direction

• Fall injury is a major cause of injury-related preventable hospitalisation and loss of independence among people aged 65 years and over in NSW (IRMRC, 2004).
• In NSW during 1998 to 2002 there were 778 deaths of people aged 65 years and over as a result of a fall (IRMRC, 2004).
• In 2002/03, 20,835 people aged 65 years and over were hospitalised in NSW as a result of a fall-related injury, giving a hospitalisation rate of 2,316 per 100,000 persons (IRMRC, 2004)
• No other single injury cause, including road trauma, costs the health system more than fall injury. In NSW the total lifetime cost of falls in 1998-99 was estimated at $644 million. This figure includes direct costs to the health system of $333 million and mortality and morbidity costs of $311 million (IRMRC, 2004).
• The aging of the population means that this problem and its associated costs are projected to rise rapidly over the coming decades. Fall injury prevention among older people has been identified as one of the priorities of NSW Health.
• In Sydney West Area Health Service in the 2003-04 financial year there were 4504 hospitalisations of older people due to falls. These involved a total of 53243 bed-days, which cost $24,668,156 in hospital costs alone. Hospitalisation rates of older people due to falls have risen over the last ten years and in 2003-04, eight of the nine Local Government Areas covered by SWAHS had higher hospitalisation rates than the state average.
• NSW Health has developed ‘The Management Policy to Reduce Fall Injury Among Older People’ which presents a state-wide collaborative framework to address the magnitude of fall related injury involving older people in NSW. It is mandatory for all Area Health Services to implement this Policy. Fall Injury Prevention indicators are included in the SWAHS Performance Agreement with the NSW Health Department.
• NSW Health is providing some support for AHSs to develop a Plan and implement the Policy in each Area.
• This process provides an opportunity for many sections of SWAHS and other organisations to work collaboratively to address fall injury among older people. It is one of the first activities since the merger of the AHSs that requires this and is thus helping to build the capacity of AHS staff to work together as one team.

Strategies:

• Lead the development of the Area Older Persons Fall Prevention Action Plan and coordinate implementation.
• Establish an Area-wide Falls Steering Committee to oversee plan development, implementation and monitoring.
• Co-ordinate and support establishment of working parties to address older persons falls prevention in key settings including Community Health Services, Acute Care Facilities, Residential Aged Care Services and the Community.
• Implement strategies and activities in the Plan where Population Health has been identified as leader, including:
  • Working with the fitness industry and older persons organisations to provide sustainable fall-safe exercise programs in community venues.
  • Working towards healthier urban planning outcomes that facilitate active ageing and provide for the health needs of frail older people.
  • Workforce development relating to fall injury prevention
  • Improving community access to information to reduce fall injury risks.
  • A communication strategy promoting wellness for older people