title: Incidence and cost of serious fall-related injuries in nursing homes.
abstract: BACKGROUND
  Fall-related injuries (FRIs) result in morbidity and mortality for patients, as well as unnecessary expense to health care institutions.
  
  
  OBJECTIVE
  (a) Estimate the incidence of falls and FRIs with a nursing home as the source of admission in Veterans Administration (VA) and non-VA facilities. (b) Estimate the cost of hospitalizations for each level of FRI severity.
  
  
  METHODS
  Retrospective analysis of falls and FRI resulting in a hospitalization whose source of admission was a VA nursing home.
  
  
  METHODS
  Falls and FRIs were obtained from Minimum Data Set (MDS) reports (January 2007-June 2009). Costs were obtained from the VA Decision Support System reports and Agency for Healthcare Research and Quality (AHRQ) Healthcare Cost and Utilization Project (HCUP) reports (2000-2006).
  
  
  METHODS
  Incidence of falls, fracture incidence, number of hospitalizations for FRIs, and costs associated with hospitalization for by level of FRI severity.
  
  
  RESULTS
  Fall incidence was 10.6% in VA and 13.1% in CMS facilities. Fracture incidence was 0.9% in VHA and 1.65% in CMS facilities. Over a 3-year period, there were 2,400 admissions to VHA hospitals for FRI, with 55.4% hip fractures and10.1% intracranial injuries, with an average cost of US$23,723 per admission. Over a 9-year period, there were 141,308 admissions from nursing homes to non-VA hospitals for FRIs, with 38.8% hip fractures, 35.7% other fractures, and 11.1% intracranial injuries, with an average cost of US$31,507 per admission.
  
  
  CONCLUSIONS
  Prevention program emphasis should shift away from a focus on preventing falls as a measure of quality care to decreasing FRIs. These findings support implementation of injury prevention programs for the elderly that reduces risk for injury as the primary outcome.
authors.affiliation: VA Hospital, Tampa, FL, USA. patricia.quigley@va.gov
authors.forename: Patricia A
authors.initials: PA
authors.lastname: Quigley
authors.forename: Robert R
authors.initials: RR
authors.lastname: Campbell
authors.forename: Tatjana
authors.initials: T
authors.lastname: Bulat
authors.forename: Ronald L
authors.initials: RL
authors.lastname: Olney
authors.forename: Peter
authors.initials: P
authors.lastname: Buerhaus
authors.forename: Jack
authors.initials: J
authors.lastname: Needleman
mesh_terms: D000058:Accidental Falls / Q000517:prevention & control / Q000706:statistics & numerical data; D006801:Humans; D015994:Incidence; D009735:Nursing Homes / Q000191:economics / Q000706:statistics & numerical data; D012189:Retrospective Studies; D015599:Trauma Severity Indices; D014481:United States / Q000453:epidemiology; D014493:United States Department of Veterans Affairs; D014947:Wounds and Injuries / Q000191:economics / Q000453:epidemiology / Q000517:prevention & control