Abstract
BackgroundIn the UK, the 2009/10 winter was characterised by sustained low temperatures; grit stocks became depleted and surfaces left untreated. We describe the relationship between temperature and emergency hospital admissions for falls on snow and ice in England, identify the age and gender of those most likely to be admitted, and estimate the inpatient costs of these admissions during the 2009/10 winter.MethodsHospital Episode Statistics were used to identify episodes of emergency admissions for falls on snow and ice during winters 2005/06 to 2009/10; these were plotted against mean winter temperature. By region, the logs of the rates of weekly emergency admissions for falls on snow and ice were plotted against the mean weekly temperature for winters 2005/06 to 2009/10 and a linear regression analysis undertaken. For the 2009/10 winter the number of emergency hospital admissions for falls on snow and ice were plotted by age and gender. The inpatient costs of admissions in the 2009/10 winter for falls on snow and ice were calculated using Healthcare Resource Group costs and Admitted Patient Care 2009/10 National Tariff Information.ResultsThe number of emergency hospital admissions due to falls on snow and ice varied considerably across years; the number was 18 times greater in 2009/10 (N = 16,064) than in 2007/08 (N = 890). There is an exponential increase [Ln(rate of admissions) = 0.456 - 0.463*(mean weekly temperature)] in the rate of emergency hospital admissions for falls on snow and ice as temperature falls. The rate of admissions in 2009/10 was highest among the elderly and particularly men aged 80 and over. The total inpatient cost of falls on snow and ice in the 2009/10 winter was 42 million GBP.ConclusionsEmergency hospital admissions for falls on snow and ice vary greatly across winters, and according to temperature, age and gender. The cost of these admissions in England in 2009/10 was considerable. With responsibility for health improvement moving to local councils, they will have to balance the cost of public health measures like gritting with the healthcare costs associated with falls. The economic burden of falls on snow and ice is substantial; keeping surfaces clear of snow and ice is a public health priority.
Highlights
In the United Kingdom (UK), the 2009/10 winter was characterised by sustained low temperatures; grit stocks became depleted and surfaces left untreated
The results show that about half the variance in the logs of the rates of emergency hospital admissions for falls on snow and ice is explained by the model, evidenced by R squared = 0.502
Inspecting the coefficient for mean temperature, B = -0.463 (t = -23.635, P < 0.001) shows there is a significant negative correlation with log of emergency hospital admissions for falls on snow and ice as expected, which means as the temperature drops, there is a corresponding exponential increase in the weekly rate of admissions [Ln(rate of admissions) = 0.456 - 0.463*(mean weekly temperature), Figure 2]
Summary
In the UK, the 2009/10 winter was characterised by sustained low temperatures; grit stocks became depleted and surfaces left untreated. Prolonged snow and icy conditions resulting in slippery roads and pavements are a problem for everyone because few people are able to avoid venturing outside for any sustained length of time. According to the Local Highways Authority, the cost of treating the roads during 2009/10 was 49% higher than it cost in the winter of 07/08, but despite the additional gritting activity, stockpiles became depleted in many areas of the UK and many surfaces were left untreated [2]. Icy conditions are known to increase the likelihood of experiencing a fall [3], with accidents resulting in various injuries, most commonly fractures and back injuries [4,5,6]. One hospital in the South West of England, for example, reported that, in the first two weeks of January 2010, the number of admissions to the emergency ward because of falls due to slipping on snow and ice, and the number of trauma operations performed, had doubled, costing an additional 227,500 GBP [7]
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