• Dharan W Sukumar, Lara A Harvey, Rebecca J Mitchell, and Jacqueline C T Close.
• Falls and Injury Prevention Group, Neuroscience Research Australia, New South Wales.
• Aust N Z J Public Health. 2016 Aug 1; 40 (4): 342-8.

ObjectiveThis population-based study investigates the influence of geographical location on hospital admissions, utilisation and outcomes for fall-related injury in older adults, adjusting for age, sex and comorbidities.MethodsA linked dataset of all admissions of NSW residents aged 65 and older, hospitalised at least once for a fall-related injury between 2003 and 2012, was used to estimate rates of hospitalisations, total lengths-of-stay, 28-day readmissions, and 30-day mortalities. These were standardised for age, sex, comorbidity, and remoteness.ResultsCompared to urban residents, rural residents were hospitalised less (p<0.0001) and hospitalisation rates increased at a lower rate (0.8% vs 2.6% per year) from 2003 to 2012. Rural residents had a shorter median total length of stay (5 vs 7 days, p<0.0001), a higher 28-day readmission rate (18.9% vs 17.0%, p<0.0001) and higher 30-day mortality (5.0% vs 4.9%, p=0.0046).ConclusionsOver the study period, rural residents of NSW had lower rates of fall-related injury hospitalisation and a lower annual increase in hospitalisation rates compared to urban residents. When hospitalised, rural residents had a shorter length-of-stay, but higher rates of readmission and mortality. These differences existed following standardisation.ImplicationsThis study highlights the need for further research to characterise and explain this variability.© 2016 Public Health Association of Australia.

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