The Centers for Medicare & Medicaid Services do not reimburse fall-related costs, so falls represent a significant cost burden for hospitals.
In hospitals, falls are the largest category of preventable adverse events, according to earlier research. Many hospital falls can be prevented through use of evidence-based programs. Falls represent a significant cost for hospitals because the Centers for Medicare & Medicaid Services discontinued fall-related cost reimbursement in 2008.
The new study, which was published by JAMA Health Forum, examined data from more than 900,000 patients, with 7,858 noninjurious falls and 2,317 injurious falls.
In addition to determining the average total cost of falls, the researchers assessed the cost effectiveness of the evidence-based Fall TIPS (Tailoring Interventions for Patient Safety) Program. The Fall TIPS Program features a three-step fall prevention process: conducting a fall risk assessment, developing a personalized fall prevention plan, and implementing tailored interventions coupled with universal fall precautions. In the new study, the Fall TIPS Program was used in 33 medical and surgical units at eight hospitals.
The new study includes four key data points:
- Before the Fall TIPS Program was implemented, there were 2,503 falls and 900 injuries. After the Fall TIPS Program was implemented from June 2013 to August 2019, there were 2,078 falls and 758 injuries.
- The average total cost of an inpatient fall was $62,521 ($35,365 in direct costs).
- The implementation of the Fall TIPS Program resulted in $14,600 in net avoided costs per 1,000 patient days, with a total cost savings over the study period of $22 million.
- The researchers estimated that the Fall TIPS Program could generate annual cost savings of $1.82 billion if implemented on a national scale, with intervention costs of $20 million.
"The findings of this study indicate that implementation of cost-effective, evidence-based safety programs was associated with lower cost and care burdens associated with inpatient falls and are a step toward safer, more affordable patient care," the study's co-authors wrote.
Interpreting the data
One of the key findings of the study was that the costs of falls with or without injury were not significantly different, the study's co-authors wrote. "This finding suggests that even in the absence of obvious injury, post-fall evaluation and testing are extensive, and [length of stay] is prolonged. Therefore, programs that prevent all falls provide the greatest cost-savings opportunities."
Injurious hospital falls result in a range of harm, the co-authors wrote. "Most major fall injuries…range in severity from those that cause temporary functional impairment (i.e., dislocated shoulder or broken teeth) to injuries associated with increased mortality (i.e., skull fractures and subdural hematomas)."
The study can guide decisions to implement evidence-based fall prevention programs at other healthcare organizations, the co-authors wrote. "This study analyzed the costs and benefits of preventing falls using the Fall TIPS Program from the healthcare system perspective. Findings can be used to assist other organizations in evaluating the decision to invest in implementing an evidence-based fall prevention program."
The results of the study show that the Fall TIPS Program is cost-effective, they wrote. "Resources to improve patient safety are limited, and the benefits associated with the Fall TIPS Program far outweigh the associated costs."
Christopher Cheney is the senior clinical care editor at HealthLeaders.
Researchers assessed the cost effectiveness of the evidence-based Fall TIPS (Tailoring Interventions for Patient Safety) Program.
The researchers estimated that the Fall TIPS Program could generate annual cost savings of $1.82 billion if implemented on a national scale, with intervention costs of $20 million.