Cost Analysis of a Falls-prevention Program in an Orthopaedic Setting

• Published in: Clinical orthopaedics and related research 2011-12, Vol.469 (12), p.3462-3468
• Main Authors: Galbraith, John G., Butler, Joseph S., Memon, Adeel R., Dolan, Mark A., Harty, James A.
• Format: Article
• Language: English
• Subjects: Accidental Falls - economics; Accidental Falls - prevention & control; Accidental Falls - statistics & numerical data; Aged; Aged, 80 and over; Biological and medical sciences; Bones of Lower Extremity - injuries; Clinical Research; Conservative Orthopedics; Cost of Illness; Costs and Cost Analysis; Diseases of the osteoarticular system; Female; Fractures, Bone - epidemiology; Hip Fractures - epidemiology; Hospital Costs; Hospitalization; Humans; Male; Medical sciences; Medicine; Medicine & Public Health; Middle Aged; Orthopedics; Prospective Studies; Risk Factors; Sports Medicine; Surgery; Surgical Orthopedics; Trauma
• ISSN: 0009-921X; 1528-1132
• DOI: 10.1007/s11999-011-1932-9

Background Falls by orthopaedic patients may lead to negative outcomes such as injury, prolonged hospitalization, delayed rehabilitation, and increased costs. Questions/purposes We examined the impact of a multidisciplinary Falls-prevention Program (FPP) on the incidence of inpatient falls and fall-related injuries in an orthopaedic hospital during a 6-year period. Methods Patient data and fall incident report data were reviewed to identify risk factors associated with falls and fall-related injuries. A cost analysis was performed to calculate costs incurred as a result of falls. Results A total of 415 falls occurred during a 5-year period preintervention. The fall rate preintervention was significantly higher than the fall rate postintervention (3.49 versus 2.68 per 1000 bed days). Eighty-five falls occurred in the 12 months preintervention. A total of 15.29% (13 of 85) of falls resulted in minor injuries, and 9.42% (eight of 85) resulted in major injuries. The total cost incurred during this period as a result of falls was $117,754.12. Of this, 95.5% resulted from patients who sustained a hip fracture (n = 4). The total cost of implementing the FPP was $15,694.46. In the 12 months postintervention, 52 falls occurred. Twenty-five percent (13 of 52) of falls resulted in minor injuries, and 5.76% (two of 52) resulted in major injuries (no hip fractures). The total costs accrued during this period as a result of falls was $811.70. Conclusions After implementation of a FPP, there were significant decreases in fall incidence, fall-related morbidity, and consequent costs. Level of Evidence Level III, economic and decision analyses. See the Guidelines for Authors for a complete description of levels of evidence.