title: The cost of serious fall-related injuries at three Midwestern hospitals.
abstract: BACKGROUND
  Consequences of fall-related injuries can be both physically and financially costly, yet without current data, hospitals cannot completely determine the financial cost. As part of the analysis for an initiative to minimize falls with injury, the cost and length of stay attributable to serious fall injury were estimated at three hospitals in a Midwestern health care system
  
  
  METHODS
  In a retrospective case-control study, 57 hospital inpatients discharged between January 1, 2004, and October 16, 2006, who sustained a serious fall-related injury (fracture, subdural hematoma, any injury resulting in surgical intervention, or death) were identified through the incident reporting system and matched to nonfaller inpatient controls by hospital, age within five years, year of discharge, and diagnosis-related group (DRG).
  
  
  RESULTS
  Multivariate analyses indicated that operational costs for fallers with serious injury, as compared with controls, were $13,316 more (p < .01; 95% confidence interval [CI], $1,395-$35,561) and that fallers stayed 6.3 days longer than nonfallers (p < .001; 95% CI, 2.4-14.9). Univariate analyses indicated they were also significantly more likely to have diabetes with organ damage, moderate to severe renal disease, and a higher mean score on the Charlson Comorbidity Index. In optimal bipartite matching (OBM) analyses, fallers with serious injury cost $13,806 more (p < .001; 95% CI, $5,808-$29,450) and stayed 6.9 days longer (p < .001; 95% CI, 2.8-14.9).
  
  
  CONCLUSIONS
  Hospital inpatients who sustained a serious fall-related injury had higher total operational costs and longer lengths of stay than nonfallers. Despite possible limitations regarding the cost allocation methods, the analysis included data from three different hospitals, and supplemental multivariate analyses adjusting for academic hospital status did not meaningfully affect the results.
authors.affiliation: Center for Clinical Excellence, BJC HealthCare, St. Louis, USA. Katie.Wong@BJC.org
authors.forename: Catherine A
authors.initials: CA
authors.lastname: Wong
authors.forename: Angela J
authors.initials: AJ
authors.lastname: Recktenwald
authors.forename: Marilyn L
authors.initials: ML
authors.lastname: Jones
authors.forename: Brian M
authors.initials: BM
authors.lastname: Waterman
authors.forename: Mara L
authors.initials: ML
authors.lastname: Bollini
authors.forename: Wm Claiborne
authors.initials: WC
authors.lastname: Dunagan
mesh_terms: D000058:Accidental Falls / Q000706:statistics & numerical data*; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D015897:Comorbidity; D003365:Costs and Cost Analysis; D005260:Female; D006739:Hospital Administration / Q000191:economics* / Q000706:statistics & numerical data*; D006801:Humans; D007902:Length of Stay / Q000191:economics / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D015146:Midwestern United States; D012189:Retrospective Studies; D012307:Risk Factors; D014947:Wounds and Injuries / Q000191:economics* / Q000453:epidemiology