The Cost of Serious Fall-Related Injuries at Three Midwestern Hospitals

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.