AI Article Synopsis
- The study aimed to assess the risks of hospital readmission, nursing home admission, and death among elderly individuals (75+) who were hospitalized after a noninjurious fall over a 6-month period.
- Fallers experienced shorter hospital stays but were more likely to be discharged to rehabilitation or long-term care, leading to increased use of these services compared to nonfallers.
- Findings suggest that elderly patients hospitalized for falls face a higher risk of institutionalization and incur greater costs for rehabilitation and long-term care, highlighting the need for targeted interventions to prevent such outcomes.
Article Abstract
Objectives: To determine the risk of hospital readmission, nursing home admission, and death, as well as health services utilization over a 6-month follow-up, in community-dwelling elderly persons hospitalized after a noninjurious fall.
Design: Prospective cohort study with 6-month follow-up.
Setting: Swiss academic medical center.
Participants: Six hundred ninety persons aged 75 and older hospitalized through the emergency department.
Measurements: Data on demographics and medical, physical, social, and mental status were collected upon admission. Follow-up data were collected from the state centralized billing system (hospital and nursing home admission) and proxies (death).
Results: Seventy patients (10%) were hospitalized after a noninjurious fall. Fallers had shorter hospital stays (median 4 vs 8 days, P<.001) and were more frequently discharged to rehabilitation or respite care than nonfallers. During follow-up, fallers were more likely to be institutionalized (adjusted hazard ratio=1.82, 95% confidence interval=1.03-3.19, P=.04) independent of comorbidity and functional and mental status. Overall institutional costs (averaged per day of follow-up) were similar for both groups ($138.5 vs $148.7, P=.66), but fallers had lower hospital costs and significantly higher rehabilitation and long-term care costs ($55.5 vs $24.1, P<.001), even after adjustment for comorbidity, living situation, and functional and cognitive status.
Conclusion: Elderly patients hospitalized after a noninjurious fall were twice as likely to be institutionalized as those admitted for other medical conditions and had higher intermediate and long-term care services utilization during follow-up, independent of functional and health status. These results provide direction for interventions needed to delay or prevent institutionalization and reduce subsequent costs.
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| http://dx.doi.org/10.1111/j.1532-5415.2006.00743.x | DOI Listing |
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