Trends and burden of hospitalization due to falls among older adults aged 60 years and older in Thailand, 2019–2023

Abstract

Introduction: Thailand has entered an ageing society, making falls a major public health problem among older adults. Falls contribute to injuries, disabilities, mortality, and increasing healthcare costs. The study aimed to describe trends and burden of fall-related hospitalizations among Thai adults aged 60 years and older from 2019 to 2023.

Methods: This quantitative study used secondary data from the Health Data Center, Ministry of Public Health. Inpatient records of individuals aged ≥60 years with ICD-10 codes W00–W19 between 2019 and 2023 were analyzed, excluding Bangkok. Hospitalization rates per 100,000 population, annual average percent change (Annual average percent change: AAPC), and differences across sex, age groups, health regions, service areas, and seasons were examined using the t-test and the chi-square test. Length of stay was also assessed.

Results: Overall hospitalization rates showed a slight declining trend during the study period, AAPC = −1.75%, with a marked decrease in 2020–2021 and a subsequent increase in 2022–2023. Females consistently had higher hospitalization rates than males, approximately 1.2 times on average. Rates increased substantially with advancing age, peaking among those aged 90 years and older. Health Regions 1 and 7 reported persistently higher rates than the national average. Approximately 19–21% of patients received care outside their area of residence, with no significant difference in mean length of stay between patients treated within and outside their province of residence. Winter accounted for the highest proportion of hospitalizations each year.

Conclusion and Recommendation: The initial decline in hospitalization rates may be associated with public health measures during the COVID-19 pandemic, whereas the subsequent increase reflects the continuing burden of falls, particularly among older females and the oldest-old. Regional disparities and cross-area utilization indicate variations in healthcare system capacity. Fall prevention strategies should begin at an early ageing, focusing on risk screening, strength and balance training, home and community environment modification, and the use of evidence-based data to support policy development and efficient allocation of healthcare resources.