Abstract

Each year, more than 110,000 people aged 65 and over end up in emergency care after a fall. In addition to the resulting physical and emotional distress, these people encounter significant medical costs. Community-dwelling elderly can avoid falls by taking part in fall prevention activities. These activities teach them to train their muscles and balance, eat healthily and have their eyes checked regularly.

Some municipalities have been working on fall prevention for years. In 2023, a chain approach to fall prevention was adopted in order to identify elderly people who are more likely to fall and to reduce the risk of fall accidents. Since that time, the central government, municipalities and healthcare insurers have been working on fall prevention together. The chain approach consists of four steps: 1. identifying which people are more likely to fall, 2. investigating which factors contribute to the increased risk of falling, 3. taking part in a fall prevention course and 4. engaging in regular physical activity and exercise.

The National Institute for Public Health and the Environment (RIVM) compiles an overview of the process, the progress and the outcomes of the fall prevention chain approach each year. This overview shows that, in 2023, many municipalities made a start with setting up the chain approach together with other parties. The municipalities, the Municipal Public Health Services and healthcare insurers considerthis to be a positive development. However, not all steps in the chain approach are being carried out yet. Furthermore, there is not enough information yet to assess whether the aims of fall prevention in the Netherlands are being achieved.

The Monitor shows that the fall prevention chain approach was offered in an increased number of municipalities in 2023, up to 271. In addition, municipalities and care insurers are working with a variety of care and well-being providers to identify which elderly people are more likely to fall. In 265 municipalities, at least one of the three certified fall prevention courses is being offered to community-dwelling elderly who are more likely to fall.

The main obstacle identified by the parties involved is the lack of information on who should examine these people in order to identify the factors that contribute to the likelihood of falling. Among other things, this is because the parties involved do not agree on which professionals should investigate this (GP practices, physiotherapists or occupational therapists).