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The Gerontologist 46:717-725 (2006)
© 2006 The Gerontological Society of America

Fall-Risk Evaluation and Management: Challenges in Adopting Geriatric Care Practices

Mary E. Tinetti, MD1, Catherine Gordon, RN, MBA2, Ellen Sogolow, PhD3, Pauline Lapin, MHS4 and Elizabeth H. Bradley, PhD1

Correspondence: Address correspondence to Mary E. Tinetti, MD, Gladys Phillips Crofoot Professor of Medicine, Public Health and Epidemiology, Yale University School of Medicine, 20 York St., TMP15, New Haven, CT 06504. E-mail: mary.tinetti{at}yale.edu

One third of older adults fall each year, placing them at risk for serious injury, functional decline, and health care utilization. Despite the availability of effective preventive approaches, policy and clinical efforts at preventing falls among older adults have been limited. In this article we present the burden of falls, review evidence concerning the effectiveness of fall-prevention services, describe barriers for clinicians and for payers in promoting these services, and suggest strategies to encourage greater use of these services. The challenges are substantial, but strategies for incremental change are available while more broad-based changes in health care financing and clinical practice evolve to better manage the multiple chronic health conditions, including falls, experienced by older Americans.

Key Words: Falls interventions • Falls prevention • Fall-risk evaluation • Medicare • Preventive approaches




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