Fall-related hospitalization and facility costs among residents of institutions providing long-term care.
OBJECTIVE
The purpose of this study was to estimate hospital and long-term-care costs resulting from falls in long-term-care facilities (LTCFs).


METHODS
The study used a retrospective, pre/post with comparison group design. We used matching, based on propensity scores, to control for baseline differences between fallers and non-fallers. We estimated residents' propensity to fall from demographics, comorbidities, and reimbursement in the pre-period. The matched sample included 1,130 fallers and 1,130 non-fallers who were residents of a large, multifacility long-term-care chain. Cost estimates were based on information in the Minimum Data Set and were defined as hospital and LTCF reimbursements. We estimated fall-related costs as the difference between changes in costs for fallers and non-fallers from the pre- to post-period.


RESULTS
Fallers were substantially more likely to suffer fractures and hospitalizations in the post-period than were non-fallers. Fall-related LTCF and hospital costs were $6,259 (95% confidence interval = $2,034-$10,484) per resident per year. About 60% of this amount was attributable to higher hospitalization costs. Fallers were more likely to be discharged to hospitals or to die.


CONCLUSIONS
Falls in LTCFs are associated with costs of about $6,200 per resident per year. These results provide baseline estimates that one may use to estimate the cost-effectiveness of interventions to reduce fall rates.
Carroll
Norman V
NV
School of Pharmacy, Virginia Commonwealth University, 410 North 12th Street, Box 980533, Richmond, VA 23298-0533, USA. nvcarroll@vcu.edu
Delafuente
Jeffrey C
JC
Cox
Fred M
FM
Narayanan
Siva
S
D000058:Accidental Falls / Q000191:economics*; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006707:Homes for the Aged; D017721:Hospital Costs; D006760:Hospitalization / Q000191:economics*; D006801:Humans; D008297:Male; D009735:Nursing Homes; D012189:Retrospective Studies