Development of an algorithm to identify fall-related injuries and costs in Medicare data.

Background: Identifying fall-related injuries and costs using healthcare claims data is cost-effective and easier to implement than using medical records or patient self-report to track falls. We developed a comprehensive four-step algorithm for identifying episodes of care for fall-related injuries and associated costs, using fee-for-service Medicare and Medicare Advantage health plan claims data for 2,011 patients from 5 medical groups between 2005 and 2009.

Methods: First, as a preparatory step, we identified care received in acute inpatient and skilled nursing facility settings, in addition to emergency department visits.

Targeting a high-risk group for fall prevention: strategies for health plans.

Objectives: Although Medicare has implemented incentives for health plans to reduce fall risk, the best way to identify older people at high risk of falling and to use screening results to target fall prevention services remains unknown. We evaluated 4 different strategies using a combination of administrative data and patient-reported information that health plans could easily obtain.

Study Design: Observational study.

Effect of a falls quality improvement program on serious fall-related injuries.

Objectives: To determine whether a program that improves the quality of care for falls reduces the number of episodes of care for serious fall-related injuries.

Design: Nonrandomized controlled trial.

Setting: Four community-based primary care practices.