A Coordinated National Response to Prevent

Falls in Older People in New Zealand

Gill Hall, Manager Rehabilitation and Falls Prevention

Accident Compensation Corporation, New Zealand

September 2015

• Number of over

65s will double

by 2035. 130%

increase in

people over 80

years old

• Increasing

numbers living

longer with long

terms conditions -

frailty

• Falls most

common cause of

injury

• High chance of

re-injury after 1st

fall; 21% likely to

have hip fracture

• Falls have

significant impact

on quality of life

Current situation Falls amongst older people: introducing Muriel

Projected new claims growth and

impacts

0

20000

40000

60000

80000

100000

120000

140000

2013 2014 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025

65-69 years 70-74 years 75-79 years 80-84 years 85+ years

Impacts are not immediate

but we need to invest now:

• in injury prevention

interventions to flatten

future demand curve

• to modernise services

and build capability to

deliver good rehab

today and future proof

for future demand

Health system impacts

Source: IPS Strategic Intelligence and Analytics, using Gravel Road’s claim rate growth assumption of 2.83%

Cla

im N

um

bers

Year

Rate of New ACC Claims

0

50

100

150

200

250

300

350

400

450

2010 2011 2012 2013 2014

Rate

per

1000 h

ead

of

po

pu

lati

on

Year

Rate of new claims per 1000 people for all claims and falls claims: calendar year 2010 to 2014

All claims - all ages

All claims - 65+

Fall claims - all ages

Fall claims - 65+

• 130,000 ACC

claims for falls

related injury /

year

e.g. DHB region

with population of

0.5 million (34,000

people over the age

of 75 years) that’s:

• 40 per week

attend an ED

• 28 admitted

• 8-9 hip

fractures

Current situation Falls amongst older people

Falls amongst older people Population at Risk over 65 years

83% Low risk 15% Moderate risk 2% High risk

1. • Funding

2. • Develop programme

3 • Contracts for delivery

4. • Audit

5. • Measure provider activity

Traditional health design model

Typical result

We can’t continue to do things in

the same way

Population-based, whole-of-system approach

Partnerships

Primary prevention, secondary prevention, rehabilitation

If you want to make a difference,

you have to do things differently

Siloes to systems

1. • Muriel’s Experience

2. • Local Community

Context

3 • Local Service

Design/Models of Care

4. • Funding Contracts

New Way of Designing Services

District Health Boards current FLS establishment levels

Pre service set up

Service set up

Initial delivery

Established delivery

20%

45%

5%

30%

Understanding local context

DHB Readiness re falls prevention

Stocktake of falls prevention activities and readiness to engage

10%

30%

30%

30%

Thinking

Talking

Planning

Doing

Copyright (c) ACC

Understanding local context

Doing things differently…

Getting well, staying well, living well in their communities

Working differently means

The key is how we work:

Common agenda

Shared measurement system

Mutually reinforcing activities

Most important role the funder

can play is focus attention on the

issue and help to create a

process that mobilises

organisations to find a solution

themselves

Any questions?

20

Thank you