Patterns of health service use before and after a statewide fall prevention initiative for older adults at risk of falls.

Objective: To understand health-care burden from fall-related injury, we investigated patterns of health service use in participants of the Australian statewide Stepping On fall prevention program.

Methods: Routinely collected ambulance, emergency, hospital and mortality data for 9163 participants across NSW Local Health Districts between 2009 and 2015 were analysed for patterns in fall-related health service use three years before and after the Stepping On program using negative binomial regression analyses.

Results: Overall fall-related health service use increased over the 6-year study period. There was a high period of usage prior to program participation, which decreased postprogram, then appeared to increase again after 12-15 months. Subgroup analysis showed strongest postprogram reductions for women.

Conclusions: Patterns of service usage suggest initial program benefits that taper off over time. The results of this observational study need to be interpreted with caution. Investment in ongoing fall prevention programs may be needed for lasting impacts.