Home' Australian Ageing Agenda : AAA Jul-Aug 2012 Contents approximately a 66 per cent reduction in
incidence" in order maintain cost parity
between now and 2051. It therefore
substantiates the need for a government
falls prevention strategy and more funding,
and urges policymakers to consider
investing now to achieve a reduction in
falls rates and in falls-related costs later.
IT'S ALL ABOUT THE MONEY
Senior principal research fellow at
Neuroscience Research Australia,
Professor Stephen Lord, stresses that an
ideal 'whole-of-government' falls strategy
must be multidisciplinary and encourage
falls prevention research; include training
and accreditation for people conducting
falls prevention exercise classes; address
all the lifestyle factors that influence fall
rates; and target older people who are at a
high risk of falling now and those who will
be at risk in the future.
"The strategy needs to be coordinated,"
Prof Lord says. "A structured approach
would increase the reach of falls
prevention exercise programs -- that's the
main thing which would mean we'd have
better programs and more of them."
Director of Health Economics and
Policy at The Centre for International
Economics, Sarina Fisher, says a whole-
of-government falls prevention strategy,
like the one suggested by Prof Lord,
could possibly reduce the overwhelming
cost of falls to the state. But, she adds,
making the argument for a holistic
approach is not as simple as it sounds.
"If you are going to save money by
spending money, you need to reduce
the risk of [a fall] happening, reduce the
severity and impact when it does happen,
and reduce the number of people it
impacts," Fisher comments.
"So if you reduce the volume, you
reduce the cost. Investing in prevention
has the potential to avoid the risk of a fall
and the potential to reduce the severity
of an injury. But, because so many things
affect a fall and the severity of a fall, falls
are hard to target."
The best thing the sector can do now to
push for a whole-of-government strategy,
she advises, is to develop a business case
for a falls strategy that clearly states,
point by point, how it will reduce the
impact and severity of a fall, and the
corresponding cost savings.
"The government wants advice and a
net return on its investments. It wants
its investments to translate into dollar
savings as well as good community
outcomes. And when you are able to
demonstrate a positive net impact from a
financial impact, then you have a policy
that might work. It's just about putting the
financial business case forward."
In 2010 and again, just recently, the
Australian Physiotherapy Association
(APA) put forward a business case to
the Department of Health and Ageing's
Aged Care Funding Instrument
(ACFI) review for restorative
assessment and treatment funding which
encompasses falls and balance for low and
high care residents.
The APA also said it wanted section
two of the ACFI, mobility, to be changed
to include a mandatory physiotherapy
falls assessment: "Where clinically
indicated, residents should be enrolled
in a physiotherapist supervised falls and
balance program that is based on current
clinical practice guidelines".
The department rejected the
association's initial falls funding wishlist
in 2011. And, vice chair of the National
Gerontology Group of the APA, Rik Dawson,
has received word that the impending
review report will bring another no.
However, Dawson believes there is still
hope. "Our next mission will be to achieve
funding through aged care reform," says
the director of Agewell Physiotherapy.
"We need to get falls prevention into the
forefront of changes in aged care. We
just need a targeted national plan that
goes from aged care into acute care, back
through into community.
"With the new funding model I think
they are seriously looking at lifestyle issues
as part of the funding mix. I do believe we
will get falls-related funding and that it
probably will happen but just not through
ACFI this time around. I think that,
with the current aged care reform, falls
prevention will be a focus. It has to be a
focus. As the baby boomers are ageing we
just can't afford not to reduce falls." n
AAA | JULY -- AUGUST 2012 | 55
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