Fall-related hospitalizations in older adults: health system burden in Split-Dalmatia County
I Marasović Šušnjara, G Glavaš, H ŠušnjaraAbstract
Background
Falls among older adults impose a substantial burden on healthcare systems due to high hospitalization, injury, and mortality rates. This study analysed trends, demographic characteristics, hospitalization rates, injury patterns, and outcomes of fall-related hospitalizations among individuals aged ≥65 years in Split-Dalmatia County, Croatia, from 2020 to 2024.
Methods
A retrospective study was conducted using hospitalization data from the National Health Information System. Falls were identified using ICD-10 codes W00–W19. Analyses included individuals aged ≥65 years, stratified by age group, sex, and year. Hospitalization rates per 100,000 population were calculated. Differences were assessed using chi-square and Kruskal–Wallis tests, and Poisson regression was used to estimate rate ratios (RRs) with 95% confidence intervals (CIs) and assess temporal trends.
Results
A total of 4,737 fall-related hospitalizations were recorded (58.3% of all cases). Rates increased with age, with individuals ≥85 years having over fivefold higher rate than those aged 65–74 (RR = 5.16, 95% CI 4.80–5.56). Women accounted for 69.8% of cases and had higher rates than men (RR = 1.74, 95% CI 1.64–1.85). Hip and femur injuries predominated (50.4%). In-hospital mortality was 3.0% and higher among men. No significant temporal trend was observed.
Conclusions
Fall-related hospitalizations represent a substantial, age-dependent burden on the healthcare system, particularly among the oldest groups. Stable rates combined with population ageing suggest increasing future demand, highlighting the need for capacity planning and optimized care pathways.
Key messages
• Fall-related hospitalizations impose a substantial, age-related burden, with ≥85-year-olds showing markedly higher rates and more severe injuries.
• Stable trends, combined with population ageing, indicate rising future demand for acute care, requiring strategic capacity planning and optimized care pathways.