Friday, 6 November 2015

The extra resource burden of in-hospital falls: a cost of falls study

Associate Professor Anna Barker and Renata Morello from SPHPM’s Falls and Bone Health team were published this week in the Medical Journal of Australia for their study examining the resource burden of in-hospital falls.

The team is part of SPHPM's Health Services Research Unit (HSRU) and leads a number of clinical research projects that generate new knowledge to improve the quality of clinical practices relating to falls prevention, bone health and healthy ageing.

Renata Morello said that, only one other Australian study had examined the demand on resources by falls in hospital and that a study of a broader acute population was needed.

“Given the lack of comprehensive and contemporary data on the cost of falls, the aim of our study was to identify the economic burden associated with in-hospital falls in Australian hospitals,” Ms Morello said.

The multisite prospective study tracked falls over a 15-month period across 12 acute public metropolitan and regional teaching hospital wards, in six hospitals, in Victoria and New South Wales.

The study discovered that in-hospital falls remain highly prevalent, with 3.6 per cent of all patient admissions resulting in at least one fall, a third of which caused a fall injury.

The total hospital costs of falls in the dataset studied was 9.8 million dollars and the average length of stay (LOS) increase in patients who experienced a fall was eight days.

Patients who experience an in-hospital fall almost double their length of stay in hospital, and the hospitals bears a significant burden in costs whether or not the fall resulted in injury.

Researchers say this may be caused by changes in the patient’s care pathway and discharge planning, as best practice guidelines currently recommend that patients who have a fall be provided with strategies that minimise risk of subsequent falls and an assessment of safety and readiness for discharge home.

“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,” Associate Professor Anna Barker said.

“Our findings highlight the fact that falls prevention programs in the acute hospital setting need to focus not only on the minimisation of harm resulting from falls, but also on the prevention of all falls. In the absence of evidence from randomised control trials that supports the effectiveness of any single falls prevention strategy in the acute hospital setting,” Ms Morello said.

“The challenge remains to develop innovative ways to prevent falls in hospital and to reduce the additional resource burden associated with these events.” 

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