Cost analysis of a falls-prevention program in an orthopaedic setting.

Background: Falls by orthopaedic patients may lead to negative outcomes such as injury, prolonged hospitalization, delayed rehabilitation, and increased costs.

Questions/purposes: We examined the impact of a multidisciplinary Falls-prevention Program (FPP) on the incidence of inpatient falls and fall-related injuries in an orthopaedic hospital during a 6-year period.

Methods: Patient data and fall incident report data were reviewed to identify risk factors associated with falls and fall-related injuries. A cost analysis was performed to calculate costs incurred as a result of falls.

Results: A total of 415 falls occurred during a 5-year period preintervention. The fall rate preintervention was significantly higher than the fall rate postintervention (3.49 versus 2.68 per 1000 bed days). Eighty-five falls occurred in the 12 months preintervention. A total of 15.29% (13 of 85) of falls resulted in minor injuries, and 9.42% (eight of 85) resulted in major injuries. The total cost incurred during this period as a result of falls was $117,754.12. Of this, 95.5% resulted from patients who sustained a hip fracture (n = 4). The total cost of implementing the FPP was $15,694.46. In the 12 months postintervention, 52 falls occurred. Twenty-five percent (13 of 52) of falls resulted in minor injuries, and 5.76% (two of 52) resulted in major injuries (no hip fractures). The total costs accrued during this period as a result of falls was $811.70.

Conclusions: After implementation of a FPP, there were significant decreases in fall incidence, fall-related morbidity, and consequent costs.

Level Of Evidence: Level III, economic and decision analyses. See the Guidelines for Authors for a complete description of levels of evidence.