Sociodemographic Patterns of Outpatient Falls: Do Minority Patients Fall Less Frequently?

Abstract

Introduction: Falls are the most common cause of injury in the elderly, resulting in $50 billion of annual spending. Social and demographic factors associated with falling are not well understood. We hypothesized minority groups (minority race, lower income, and lower education levels) would experience similar rates of falling to majority groups after adjustment for medical factors.

Material and methods: We used the 2013 Medicare Current Beneficiary Survey Public Use File, a representatively sampled cross-sectional survey of Medicare outpatients. Fall was defined as at least one self-reported fall in the previous year. Logistic regression was performed to determine sociodemographic factors (age, sex, race, ethnicity, income, education level, and marital status) associated with fall. Health factors, physical limitations, and cognitive limitations were included as possible confounders. Data are presented as extrapolated weighted population proportions (±SE).

Results: 13,924 Medicare beneficiaries, representing 47 million people, were included. 26.6% (±0.4) reported falling. In adjusted logistic regression, black and Hispanic patients had significantly fewer self-reported falls than white patients, after adjustment for medical conditions, physical limitations, and cognitive limitations.

Discussion: Black and Hispanic Medicare patients are significantly less likely to have reported a fall than non-Hispanic whites. This finding differs from other health-related disparities in which minorities most commonly experience higher risk or more severe diseases. These data may also represent differences in self-reporting, indicating disparities in self-reported data in these cohorts. Further studies on social factors related to falling are needed in this population.

Keywords: Falls; Geriatric trauma; Health disparities.