1564 INCIDENCE AND HEALTHCARE COST OF FALL-RELATED READMISSIONS AFTER DISCHARGE AMONG OLDER PATIENTS

• Published in: Age and ageing 2023-07, Vol.52 (Supplement_2)
• Main Authors: Xing Qian, X, Hing Chau, P, Fong, D Y T, Ho, M, Woo, J
• Format: Article
• Language: English
• Subjects: Caregivers; Cohort analysis; Costs; Critical incidents; Falls; Health care; Health care expenditures; Hospitalization; Hospitals; Inpatient care; Medical diagnosis; Medical personnel; Mobility; Muscle strength; Patient admissions; Patients; Physical ability; Physical activity; Population studies; Readmission; Womens health
• ISSN: 0002-0729; 1468-2834
• DOI: 10.1093/ageing/afad104.066

Abstract Introduction Older patients are vulnerable to falls after discharge as hospitalization could induce declines in physical function, mobility, and muscle strength. Falls may cause readmissions and subsequent healthcare burden. However, such incidence rates and costs have not been understudied. This study aimed to investigate the incidence and costs of fall-related readmissions in older patients. Method A population-based retrospective cohort study was conducted among patients aged 65 or over and discharged from public hospitals in Hong Kong from 2007 to 2017. The administrative data for inpatient admission were obtained from the Hospital Authority Data Collaboration Lab. The fall-related readmissions within 12 months following discharge were identified by the International Classification of Diseases code of diagnosis. The incidence rates were calculated in terms of person-years. The costs were computed based on the public ward maintenance fees adopted since 2007. Results In total, 611,349 older patients with a mean (SD) age of 75.3(7.6) were analyzed. Within 12 months after discharge, 18,608 patients (3.0%) had 20,666 fall-related readmissions, giving an incidence rate of 35.2 per 1000 person-years. Meanwhile, such rates (per 1000 person-years) were 44.7 for women, 25.5 for men, 20.5 for patients aged 65-74, 41.0 for patients aged 75-84, and 76.2 for patients aged ≥85. The annual cost exceeded HKD 145.6 million (23.9 million USD PPP in 2018) for older patients, and the mean cost per fall-related readmission was HKD 7,827 (1,286 USD PPP). Conclusion The fall-related hospital readmissions were important adverse events during the transitional period and caused a considerable healthcare burden to the patients, family caregivers, and the health system. Health professionals are suggested to implement interventions during hospitalizations or at the early stage after discharge to reduce falls, particularly for women and patients aged ≥85. For instance, increase physical activity during the hospital stay can be considered for fall prevention.