The impact of falls on the need for hospital care in older people: results from the Pro.V.A. study

Background and aims. Falls have been associated with adverse health-related outcomes in older people, but their effects on the need for hospital admissions is unclear. We investigated the association between falls and all-cause hospitalizations in older people. Methods. A sample of 2,123 community-dwelling adults aged >= 65 underwent multidimensional assessment at baseline and after 4.4 years. Self-reported falls in the year before baseline and in the year before the 4.4-year assessment were categorized as none, one, or >= 2 (recurrent falls). The hospitalizations number over 7 years after baseline was obtained from medical records. The association between falls and hospitalizations number was investigated using multivariable generalized mixed models with a Poisson distribution. Possible modifying effects of sociodemographic and medical factors on the studied association was investigated through interaction analysis. Results. Compared with no falls, the annual hospitalizations number for people who reported recurrent falls increased by 1.38 (95% CI: 1.05-1.81) in the short-term (over one year) and by 1.20 (95% CI: 1.031.39) in the long term (over 3.5 years). That increase was more marked in the first two years after the fall, then tended to lessen over time. No significant modifying effects on the association between falls and hospitalizations number were found. Conclusions. Recurrent falls may result in a greater need for hospital-based care, both in the short term, and, although to a lesser extent, in the long term. Since older people account for more than one in three inpatients, identifying modifiable factors for hospitalization, e.g. falls, is essential from clinical and public health perspectives.