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A Coordinated National Response to Prevent
Falls in Older People in New Zealand
Gill Hall, Manager Rehabilitation and Falls Prevention
Accident Compensation Corporation, New Zealand
September 2015
• Number of over
65s will double
by 2035. 130%
increase in
people over 80
years old
• Increasing
numbers living
longer with long
terms conditions -
frailty
• Falls most
common cause of
injury
• High chance of
re-injury after 1st
fall; 21% likely to
have hip fracture
• Falls have
significant impact
on quality of life
Current situation Falls amongst older people: introducing Muriel
Projected new claims growth and
impacts
0
20000
40000
60000
80000
100000
120000
140000
2013 2014 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025
65-69 years 70-74 years 75-79 years 80-84 years 85+ years
Impacts are not immediate
but we need to invest now:
• in injury prevention
interventions to flatten
future demand curve
• to modernise services
and build capability to
deliver good rehab
today and future proof
for future demand
Health system impacts
Source: IPS Strategic Intelligence and Analytics, using Gravel Road’s claim rate growth assumption of 2.83%
Cla
im N
um
bers
Year
Rate of New ACC Claims
0
50
100
150
200
250
300
350
400
450
2010 2011 2012 2013 2014
Rate
per
1000 h
ead
of
po
pu
lati
on
Year
Rate of new claims per 1000 people for all claims and falls claims: calendar year 2010 to 2014
All claims - all ages
All claims - 65+
Fall claims - all ages
Fall claims - 65+
• 130,000 ACC
claims for falls
related injury /
year
e.g. DHB region
with population of
0.5 million (34,000
people over the age
of 75 years) that’s:
• 40 per week
attend an ED
• 28 admitted
• 8-9 hip
fractures
Current situation Falls amongst older people
Falls amongst older people Population at Risk over 65 years
83% Low risk 15% Moderate risk 2% High risk
1. • Funding
2. • Develop programme
3 • Contracts for delivery
4. • Audit
5. • Measure provider activity
Traditional health design model
Population-based, whole-of-system approach
Partnerships
Primary prevention, secondary prevention, rehabilitation
If you want to make a difference,
you have to do things differently
1. • Muriel’s Experience
2. • Local Community
Context
3 • Local Service
Design/Models of Care
4. • Funding Contracts
New Way of Designing Services
District Health Boards current FLS establishment levels
Pre service set up
Service set up
Initial delivery
Established delivery
20%
45%
5%
30%
Understanding local context
DHB Readiness re falls prevention
Stocktake of falls prevention activities and readiness to engage
10%
30%
30%
30%
Thinking
Talking
Planning
Doing
Copyright (c) ACC
Understanding local context
Most important role the funder
can play is focus attention on the
issue and help to create a
process that mobilises
organisations to find a solution
themselves
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