Epidemiology of ambulance responses to older people who have fallen in New South Wales, Australia

Authors

  • Paul M Simpson,

    Corresponding author
    1. School of Public Health and Community Medicine, University of New South Wales, Sydney, New South Wales, Australia
    • Ambulance Service of New South Wales, Sydney, New South Wales, Australia
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  • Jason C Bendall,

    1. Ambulance Service of New South Wales, Sydney, New South Wales, Australia
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  • Jillian Patterson,

    1. New South Wales Health Biostatistical Training Program, Sydney, New South Wales, Australia
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  • Anne Tiedemann,

    1. The George Institute for Global Health, Sydney, New South Wales, Australia
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  • Paul M Middleton,

    1. Ambulance Service of New South Wales, Sydney, New South Wales, Australia
    2. School of Public Health and Community Medicine, University of New South Wales, Sydney, New South Wales, Australia
    3. University of Sydney, Sydney, New South Wales, Australia
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  • Jacqueline CT Close

    1. Falls and Injury Prevention Group, Neuroscience Research Australia, University of New South Wales
    2. Prince of Wales Clinical School, University of New South Wales, Sydney, New South Wales, Australia
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Correspondence to: Mr Paul Simpson, Ambulance Service of New South Wales. Email: psimpson@ambulance.nsw.gov.au

Abstract

Aim

To quantify the size and scope of the operational burden for a large ambulance service arising from older people who have fallen and to describe this population.

Methods

Retrospective analysis of ambulance records from New South Wales, Australia for emergency calls classified as ‘falls’ in the period 1 July 2008 to 30 June 2009.

Results

There were 42 331 responses to people aged 65 years or older, constituting 5.1% of total emergency workload. The median age of patients was 83 (interquartile range 76–87) and 62% were women. The transport rate was 76%. Transport to hospital was more likely during the day (odds ratio (OR) 1.8, 95% confidence interval (CI) 1.7–1.9) and on weekends (OR 1.06, 95%CI 1.0–1.1).

Conclusion

Falls by older people constitute approximately 5% of all emergency responses, of which one quarter are not transported to emergency department (ED) after paramedic assessment. Increasing the sophistication of ambulance dispatch processes to older people who have fallen, and continuing with the development of new models of care aimed at decreasing unnecessary transports to the EDs, should be a priority when planning ambulance service delivery for older people who have fallen.

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