The extra resource burden of in-hospital falls

a cost of falls study

Renata Morello, Anna Barker, Jennifer Joy Watts, Terrence Peter Haines, Silva Zavarsek, Keith David Hill, Caroline Anne Brand, Catherine Sherrington, Rory St John Wolfe, Megan Anne Bohensky, Johannes Uiltje Stoelwinder

Research output: Contribution to journalArticleResearchpeer-review

33 Citations (Scopus)

Abstract

OBJECTIVE: To quantify the additional hospital length of stay (LOS) and costs associated with in-hospital falls and fall injuries in acute hospitals in Australia.

DESIGN, SETTING AND PARTICIPANTS: A multisite prospective cohort study conducted during 2011-2013 in the control wards of a falls prevention trial (6-PACK). The trial included all admissions to 12 acute medical and surgical wards of six Australian hospitals. In-hospital falls data were collected from medical record reviews, daily verbal reports by ward nurse unit managers, and hospital incident reporting and administrative databases. Clinical costing data were linked for three of the six participating hospitals to calculate patient-level costs.

OUTCOME MEASURES: Hospital LOS and costs associated with in-hospital falls and fall injuries for each patient admission.

RESULTS: We found that 966 of a total of 27 026 hospital admissions (3.6%) involved at least one fall, and 313 (1.2%) at least one fall injury, a total of 1330 falls and 418 fall injuries. After adjustment for age, sex, cognitive impairment, admission type, comorbidity and clustering by hospital, patients who had an in-hospital fall had a mean increase in LOS of 8 days (95% CI, 5.8-10.4; P < 0.001) compared with non-fallers, and incurred mean additional hospital costs of $6669 (95% CI, $3888-$9450; P < 0.001). Patients with a fall-related injury had a mean increase in LOS of 4 days (95% CI, 1.8-6.6; P = 0.001) compared with those who fell without injury, and there was also a tendency to additional hospital costs (mean, $4727; 95% CI, -$568 to $10 022; P = 0.080).

CONCLUSION: Patients who experience an in-hospital fall have significantly longer hospital stays and higher costs. Programs need to target the prevention of all falls, not just the reduction of fall-related injuries.

Original languageEnglish
Pages (from-to)367.e1 - 367.e8
Number of pages8
JournalMedical Journal of Australia
Volume203
Issue number9
DOIs
Publication statusPublished - 2 Nov 2015

Cite this

@article{209032f4189e40db806b341f5cf91918,
title = "The extra resource burden of in-hospital falls: a cost of falls study",
abstract = "OBJECTIVE: To quantify the additional hospital length of stay (LOS) and costs associated with in-hospital falls and fall injuries in acute hospitals in Australia.DESIGN, SETTING AND PARTICIPANTS: A multisite prospective cohort study conducted during 2011-2013 in the control wards of a falls prevention trial (6-PACK). The trial included all admissions to 12 acute medical and surgical wards of six Australian hospitals. In-hospital falls data were collected from medical record reviews, daily verbal reports by ward nurse unit managers, and hospital incident reporting and administrative databases. Clinical costing data were linked for three of the six participating hospitals to calculate patient-level costs.OUTCOME MEASURES: Hospital LOS and costs associated with in-hospital falls and fall injuries for each patient admission.RESULTS: We found that 966 of a total of 27 026 hospital admissions (3.6{\%}) involved at least one fall, and 313 (1.2{\%}) at least one fall injury, a total of 1330 falls and 418 fall injuries. After adjustment for age, sex, cognitive impairment, admission type, comorbidity and clustering by hospital, patients who had an in-hospital fall had a mean increase in LOS of 8 days (95{\%} CI, 5.8-10.4; P < 0.001) compared with non-fallers, and incurred mean additional hospital costs of $6669 (95{\%} CI, $3888-$9450; P < 0.001). Patients with a fall-related injury had a mean increase in LOS of 4 days (95{\%} CI, 1.8-6.6; P = 0.001) compared with those who fell without injury, and there was also a tendency to additional hospital costs (mean, $4727; 95{\%} CI, -$568 to $10 022; P = 0.080).CONCLUSION: Patients who experience an in-hospital fall have significantly longer hospital stays and higher costs. Programs need to target the prevention of all falls, not just the reduction of fall-related injuries.",
author = "Renata Morello and Anna Barker and Watts, {Jennifer Joy} and Haines, {Terrence Peter} and Silva Zavarsek and Hill, {Keith David} and Brand, {Caroline Anne} and Catherine Sherrington and Wolfe, {Rory St John} and Bohensky, {Megan Anne} and Stoelwinder, {Johannes Uiltje}",
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The extra resource burden of in-hospital falls : a cost of falls study. / Morello, Renata; Barker, Anna; Watts, Jennifer Joy; Haines, Terrence Peter; Zavarsek, Silva; Hill, Keith David; Brand, Caroline Anne; Sherrington, Catherine; Wolfe, Rory St John; Bohensky, Megan Anne; Stoelwinder, Johannes Uiltje.

In: Medical Journal of Australia, Vol. 203, No. 9, 02.11.2015, p. 367.e1 - 367.e8.

Research output: Contribution to journalArticleResearchpeer-review

TY - JOUR

T1 - The extra resource burden of in-hospital falls

T2 - a cost of falls study

AU - Morello, Renata

AU - Barker, Anna

AU - Watts, Jennifer Joy

AU - Haines, Terrence Peter

AU - Zavarsek, Silva

AU - Hill, Keith David

AU - Brand, Caroline Anne

AU - Sherrington, Catherine

AU - Wolfe, Rory St John

AU - Bohensky, Megan Anne

AU - Stoelwinder, Johannes Uiltje

PY - 2015/11/2

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N2 - OBJECTIVE: To quantify the additional hospital length of stay (LOS) and costs associated with in-hospital falls and fall injuries in acute hospitals in Australia.DESIGN, SETTING AND PARTICIPANTS: A multisite prospective cohort study conducted during 2011-2013 in the control wards of a falls prevention trial (6-PACK). The trial included all admissions to 12 acute medical and surgical wards of six Australian hospitals. In-hospital falls data were collected from medical record reviews, daily verbal reports by ward nurse unit managers, and hospital incident reporting and administrative databases. Clinical costing data were linked for three of the six participating hospitals to calculate patient-level costs.OUTCOME MEASURES: Hospital LOS and costs associated with in-hospital falls and fall injuries for each patient admission.RESULTS: We found that 966 of a total of 27 026 hospital admissions (3.6%) involved at least one fall, and 313 (1.2%) at least one fall injury, a total of 1330 falls and 418 fall injuries. After adjustment for age, sex, cognitive impairment, admission type, comorbidity and clustering by hospital, patients who had an in-hospital fall had a mean increase in LOS of 8 days (95% CI, 5.8-10.4; P < 0.001) compared with non-fallers, and incurred mean additional hospital costs of $6669 (95% CI, $3888-$9450; P < 0.001). Patients with a fall-related injury had a mean increase in LOS of 4 days (95% CI, 1.8-6.6; P = 0.001) compared with those who fell without injury, and there was also a tendency to additional hospital costs (mean, $4727; 95% CI, -$568 to $10 022; P = 0.080).CONCLUSION: Patients who experience an in-hospital fall have significantly longer hospital stays and higher costs. Programs need to target the prevention of all falls, not just the reduction of fall-related injuries.

AB - OBJECTIVE: To quantify the additional hospital length of stay (LOS) and costs associated with in-hospital falls and fall injuries in acute hospitals in Australia.DESIGN, SETTING AND PARTICIPANTS: A multisite prospective cohort study conducted during 2011-2013 in the control wards of a falls prevention trial (6-PACK). The trial included all admissions to 12 acute medical and surgical wards of six Australian hospitals. In-hospital falls data were collected from medical record reviews, daily verbal reports by ward nurse unit managers, and hospital incident reporting and administrative databases. Clinical costing data were linked for three of the six participating hospitals to calculate patient-level costs.OUTCOME MEASURES: Hospital LOS and costs associated with in-hospital falls and fall injuries for each patient admission.RESULTS: We found that 966 of a total of 27 026 hospital admissions (3.6%) involved at least one fall, and 313 (1.2%) at least one fall injury, a total of 1330 falls and 418 fall injuries. After adjustment for age, sex, cognitive impairment, admission type, comorbidity and clustering by hospital, patients who had an in-hospital fall had a mean increase in LOS of 8 days (95% CI, 5.8-10.4; P < 0.001) compared with non-fallers, and incurred mean additional hospital costs of $6669 (95% CI, $3888-$9450; P < 0.001). Patients with a fall-related injury had a mean increase in LOS of 4 days (95% CI, 1.8-6.6; P = 0.001) compared with those who fell without injury, and there was also a tendency to additional hospital costs (mean, $4727; 95% CI, -$568 to $10 022; P = 0.080).CONCLUSION: Patients who experience an in-hospital fall have significantly longer hospital stays and higher costs. Programs need to target the prevention of all falls, not just the reduction of fall-related injuries.

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