ICD-10 Coding Uncovers Higher Rate of Fatal Falls Among Seniors
"This calls attention to the fact that falls are an extremely important cause of morbidity and mortality in the elderly, and now we're starting to see what the real numbers are. They are far and away the leading cause of death in the elderly."
The greatest increase, her research discovered, was a 698% increase in mortality coding under the category "other falls on the same level," falls that aren't as likely to result in injury as a fall down a flight of stairs, for example.
In 1999, the first year of ICD-10, only 1.6 people age 65 or older per 100,000 population were said to have died from a fall on the same level. But by 2007, that had jumped to 13 per 100,000.
These same-level falls, perhaps resulting after someone loses one's balance, occur more often in the elderly and don't result in injuries that are immediately life threatening.
Instead, they prompt a trip to the doctor or hospital, a diagnosis of a broken or fractured hip, and often complications from surgery or pneumonia weeks or months later. Before the switch to ICD-10 in 1999, Baker says, physicians signing death certificates were more likely to code such deaths as simply resulting from pneumonia or other complications, and ignore the fall that precipitated it weeks before.
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