What is the economic burden of fall injuries in India?

Economic Burden of Fall Injuries in India

Fall injuries in India represent a significant economic burden, with higher out-of-pocket expenditure and catastrophic health expenditure compared to other injuries, particularly affecting households seeking treatment in private facilities. 1

Magnitude of the Problem

• Fall injuries are the second most common mechanism of trauma in India after road traffic injuries, with an annual incidence of 3.30% for men and 9.22% for women based on a 3-month recall period 2
• The economic burden of falls is particularly concerning as falls affect the most productive age group (15-60 years), increasing disability-adjusted life years (DALYs) and resulting in substantial financial burden on households 1
• Disease burden due to falls is represented by high DALYs, while the economic burden manifests as out-of-pocket expenditure (OOPE) and catastrophic health expenditure (CHE) 1

Financial Impact

• Out-of-pocket expenditure for injury treatment, including falls, is approximately five times higher in private facilities compared to public facilities 1
• Households seeking treatment for fall injuries in private facilities face three times higher catastrophic expenditure compared to those utilizing public hospitals 1
• The economic burden varies by state, with residents of Punjab, Haryana, UP, Gujarat, Karnataka, and Andhra Pradesh more likely to approach private facilities for injury treatment, potentially facing higher financial burden 1

Population Most Affected

• Women have a higher incidence of fall-related injuries (9.22%) compared to men (3.30%), with the incidence increasing with age 2
• The elderly population is particularly vulnerable, with fall prevalence ranging from 26% to 37% across various regions in India 3
• In pediatric populations, fall-related injuries are most common among children aged two to five years, with an in-hospital mortality rate of 7.8% 4
• For adults, the overall in-hospital mortality from falls is 18%, rising to 39% among patients over 65 years of age 5

Healthcare Utilization and Treatment Costs

• 56% of fall injury victims report seeking treatment outside home, with women constituting 74.6% of these cases 2
• 8.4% of fall injury cases require hospital admission, contributing to higher healthcare costs 2
• Traumatic brain injury (TBI) is diagnosed in 79.9% of hospitalized fall patients and is the main contributor to mortality, potentially increasing treatment costs and long-term care needs 5

Regional Variations

• States like Jammu and Kashmir, Orissa, West Bengal, and the North East show higher utilization of public facilities for injury treatment, potentially facing lower direct costs but still experiencing significant economic burden 1
• The economic impact varies across regions, influenced by healthcare-seeking behavior and availability of public versus private facilities 1

Prevention and Policy Implications

• The high economic burden of falls highlights the need for effective financial protection approaches like PM-JAY (Pradhan Mantri Jan Arogya Yojana) to minimize the financial burden incurred due to injuries in India 1
• Targeted fall prevention strategies could significantly reduce both the health and economic burden, particularly for high-risk groups like women and the elderly 3, 2