Fall-related hospitalisations of older Aboriginal and Torres Strait Islander people and other Australians

Objectives: To compare the socio-demographic characteristics and type of injury sustained, the use of hospital resources and rates of hospitalisation by injury type, and survival following fall injuries to older Aboriginal people and non-Indigenous Australian people hospitalised for fall-related injuries. Design: Population-based retrospective cohort data linkage study. Setting, participants: New South Wales residents aged 50 years or more admitted to a public or private NSW hospital for a fall-related injury during 1 January 2003 - 31 December 2012. Main outcome measures: Proportions of patients with defined injury types, mean hospital length of stay (LOS), 30-day mortality, age-standardised hospitalisation rates and age-adjusted rate ratios, 28-day re-admission rates. Results: There were 312 758 fall-related injury hospitalisations for 234 979 individuals; 2660 admissions (0.85%) were of Aboriginal people. The proportion of hospitalisations for fall-related fracture injuries was lower for Aboriginal than for non-Indigenous Australians (49% v 60% of fall-related hospitalisations; P < 0.001). The major injury type for Aboriginal patients was non-fracture injury to head or neck (19% of hospitalisations); for non-Indigenous patients it was hip fractures (18%). Age-adjusted LOS was lower for Aboriginal than for non-Indigenous patients (9.1 v 14.0 days; P < 0.001), as was 30-day mortality (2.9% v 4.2%; P < 0.001). For Aboriginal people, fall injury hospitalisations increased at an annual rate of 5.8% (95% CI, 4.0-7.7%; P < 0.001); for non-Indigenous patients, the mean annual increase was 2.5% (95% CI, 2.1-3.0; P < 0.001). Conclusions: The patterns of injury and outcomes of fall injury hospitalisations were different for older Aboriginal people and other older Australians, suggesting that different approaches are required to prevent and treat fall injuries.