Falls in the acute hospital setting — impact on resource utilisation

Abstract

To determine the resource utilisation of patients who fall within an acute metropolitan hospital. Retrospective observational study, part of a larger falls prevention project in a 323-bed acute care, tertiary teaching hospital in Melbourne, Australia. A review of falls incidents was undertaken for all patient admissions for 18 months from January 2002, excluding the Day Procedure Unit, Intensive Care Unit, Coronary Care Unit and the Emergency Department. The most common diagnosis related groups (DRGs) associated with fallers were identified, and within each DRG, fallers were matched to non-fallers by age and gender. Difference in hospital length of stay (LOS) and disparity in resource consumption by these two groups were calculated. The DRG with the highest proportion of fallers was "Dementia and other chronic disturbances of cerebral function" (24%). Three of the top six DRGs had significantly longer LOS for fallers compared with non-fallers ("Delirium", "Stroke" and "Respiratory conditions") (P<0.05). Hospital-related costs were significantly higher for fallers compared with non-fallers for the DRG "Stroke with severe/complicating diagnosis/procedure" only (P<0.05). Inpatient LOS and total associated costs for patients who fell and were classified among the DRGs with the highest proportion of fallers were substantially higher than those of matched non-fallers. Effective falls prevention activities targeting these high-risk groups should be a priority, in the context of broader falls prevention activities within a hospital setting.