August 2018

PT Assessment, Referrals by ER Staff after a Fall May Reduce Revisits

In 2014, about 2.8 million older adults visited the emergency room (ER) for a fall-related injury. Some estimates show that 25% of older adults visiting the ER for a fall returned for at least one additional fall-related visit, and 15% of those older adults died within the following year. A new study, published in the Journal of the American Geriatrics Society, suggests that ERs could play an important role in lowering fall-related ER revisits. That role is primarily to connect people treated for a fall to appropriate follow-up care.

Researchers from West Health Institute, La Jolla, CA, used Medicare claims data to explore whether older adults who received physical therapy (PT) services while in the ER for a fall experienced fewer fall-related revisits to the ER; PT services in the ER can include getting information, a diagnosis, and a referral for follow-up PT care after discharge. The researchers compared differences in 30- and 60-day ER repeat visit rates among those who did and did not receive PT services in the ER after a fall. They found that receiving PT services in the ER during an initial visit for a fall was linked to a lower chance of returning to the ER for another fall within 30 and 60 days.

This work builds on a body of knowledge that shows when older adults follow special PT or exercise routines after a fall, they can reduce the risk of recurrence. Despite these findings, PT assessments and referral services remain rare in the ER.

“In our sample, only 3.2 percent of older adults who had a fall-related [ER] visit received PT services during that visit,” said the researchers.

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