What are the direct medical costs of fall injuries in India, including costs for procedures, hospital stays, and pharmaceuticals?

Direct Medical Costs of Fall Injuries in India

The direct medical costs of fall injuries in India are substantial, with out-of-pocket expenditure being five times higher in private facilities compared to public facilities, and households seeking treatment in private facilities facing three times higher risk of catastrophic health expenditure. 1

Economic Burden Overview

• Fall injuries represent a significant economic burden globally, with national fall-related costs ranging from 0.85% to 1.5% of total healthcare expenditures and 0.07% to 0.20% of GDP in various countries 2
• In India specifically, injuries including 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

Cost Breakdown in India

Hospital Stay Costs

• Private facility treatment costs for fall injuries are approximately five times higher than public facility costs in India 1
• Regional variations exist in healthcare facility utilization:
  • People in Punjab, Haryana, UP, Gujarat, Karnataka, and Andhra Pradesh predominantly use private facilities for fall injuries 1
  • Residents of Jammu and Kashmir, Orissa, West Bengal, and North East states more frequently utilize public facilities 1

Procedure-Related Costs

• Fall injuries, particularly those resulting in traumatic brain injuries (TBI), contribute significantly to medical costs 3
• Diagnostic procedures, especially radiology, represent a substantial component of costs for fall injuries, particularly in the immediate post-fall period 4
• For hospitalized falls, inpatient care and post-acute care components drive the largest increases in costs 4

Pharmaceutical Costs

• While specific pharmaceutical cost data for India is limited in the evidence, medication costs are included in the overall out-of-pocket expenditures for fall injuries 1
• Pharmacy costs represent one of the seven major cost components associated with fall injuries, alongside inpatient, outpatient, emergency, radiology, post-acute care, and "other" services 4

Cost Variations by Population and Injury Severity

• Pediatric falls represent a significant burden in urban India:

  • Children aged 2-5 years constitute the majority (40%) of pediatric fall admissions 3
  • Traumatic brain injury is the most common injury (71%) in fatal pediatric falls 3
  • Male children have significantly higher mortality (9%) compared to female children (5%) 3

• Severity of falls significantly impacts costs:

  • Hospitalized falls generate substantially higher costs than non-hospitalized falls 4
  • Non-hospitalized falls primarily incur costs in outpatient and "other" components (e.g., ambulatory surgery, community health services) 4

Financial Protection Considerations

• A high proportion of Indian households are pushed into catastrophic expenditure due to high out-of-pocket expenses for injury treatment, including falls 1
• Financial protection approaches like PM-JAY (Pradhan Mantri Jan Arogya Yojana) are needed to minimize the financial burden of fall injuries in India 1
• The economic burden of road traffic injuries and falls is particularly high compared to other injury types in India 1

Prevention Economics

• Fall prevention programs should be prioritized as they can be cost-effective in reducing the substantial economic burden of falls 2
• Economic evaluations should focus on prevention programs targeting fall-related fractures, which contribute substantially to fall-related costs 2