Abstract
ObjectiveTo examine the predictive power of state-level care utilization and longitudinal trends in mortality from unintentional falls amongst different demographic and geographic strata.Study DesignNationwide, retrospective cohort study.SettingWeb-based Injury Statistics Query and Reporting System (WISQARS) database.MethodsThe exposure was death from an unintentional fall as determined by the United States Centers for Disease Control. Outcomes included aggregate and trend crude and age adjusted death rates. Health care utilization, reimbursement, and cost metrics were also compared.ResultsOver 2001 to 2018, 465,486 total deaths due to unintentional falls were recorded with crude and age-adjusted rates of 8.42 and 7.76 per 100,000 population. Comparing age-adjusted rates, males had a significantly higher age-adjusted death rate (9.89 vs. 6.17; p < 0.00001), but both male and female annual age-adjusted mortality rates are expected to rise (Male: +0.25 rate/year, R 2 = 0.98; Female: +0.22 rate/year, R 2 = 0.99). There were significant increases in death rates commensurate with increasing age, with the adults aged 85 years or older having the highest aggregate (201.1 per 100,000) and trending death rates (+ 8.75 deaths per 100,000/year, R 2 = 0.99). Machine learning algorithms using health care utilization data were accurate in predicting state-level age-adjusted death rates.ConclusionIn the United States from 2001 through 2018, older adults carried the highest death rate from unintentional falls and this rate is forecasted to accelerate. Machine learning models have high accuracy in predicting state-level age-adjusted mortality rates from health care utilization data.