Fall-Related Hospitalization and Facility Costs among Residents of Institutions Providing Long-Term Care

• Published in: The Gerontologist Vol. 48; no. 2; pp. 213 - 222
• Main Authors: Carroll, Norman V, Delafuente, Jeffrey C, Cox, Fred M, Narayanan, Siva
• Format: Journal Article
• Language: English
• Published: United States Gerontological Society of America 01.04.2008
• Subjects: Accidental Falls - economics; Aged; Aged, 80 and over; Comparative Analysis; Computation; Cost Effectiveness; Costs; Female; Gerontology; Homes for the Aged; Hospital Costs; Hospitalization - economics; Hospitals; Humans; Individual Characteristics; Injuries; Institutionalized Persons; Intervention; Male; Nursing Homes; Older Adults; Regression (Statistics); Retrospective Studies
• ISSN: 0016-9013
• DOI: 10.1093/geront/48.2.213

Purpose: The purpose of this study was to estimate hospital and long-term-care costs resulting from falls in long-term-care facilities (LTCFs). Design and 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. Implications: 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.