TY - JOUR
T1 - A taxonomy and economic consequences of nursing home falls
AU - Sorensen, Sonja V.
AU - De Lissovoy, Gregory
AU - Kunaprayoon, Dan
AU - Resnick, Barbara
AU - Rupnow, Marcia F T
AU - Studenski, Stephanie
PY - 2006
Y1 - 2006
N2 - Background: Falls are a primary cause of injury and disability in the nursing home environment and can be costly to treat. We propose a taxonomy of nursing home falls that accounts for both the severity of fall consequences and the duration of the treatment episode. No other systematic approach of this kind has been previously described. Methods: We defined a 9-level taxonomy of fall types and outcomes. Components of each fall category include resource use during the acute, convalescent, and long-term phases of treatment. Three variants of each category describe typical, best-case and worst-case fall episodes. Treatment costs were estimated for each fall category by applying unit costs from national databases and published sources to projected medical resource utilisation. Long-term costs reflect adjustment in Medicare per diem reimbursement rates associated with change in patient status subsequent to the fall. Results: The most common and least costly fall category was category 1 - noninjurious, which accounted for 30% of falls and a 1-year cost of $US319 per event (range $US71-550). The least common and most costly was fall category 9 - multiple injuries, which accounted for 1% of falls and a 1-year cost of $US22 368 (range $US9969-64 382). Conclusions: The falls taxonomy represents a unique approach to estimating the cost of nursing home falls and offers a tool for evaluating the cost-effectiveness of fall prevention strategies. A validation study should be performed to confirm the magnitude of fall frequency and cost estimates.
AB - Background: Falls are a primary cause of injury and disability in the nursing home environment and can be costly to treat. We propose a taxonomy of nursing home falls that accounts for both the severity of fall consequences and the duration of the treatment episode. No other systematic approach of this kind has been previously described. Methods: We defined a 9-level taxonomy of fall types and outcomes. Components of each fall category include resource use during the acute, convalescent, and long-term phases of treatment. Three variants of each category describe typical, best-case and worst-case fall episodes. Treatment costs were estimated for each fall category by applying unit costs from national databases and published sources to projected medical resource utilisation. Long-term costs reflect adjustment in Medicare per diem reimbursement rates associated with change in patient status subsequent to the fall. Results: The most common and least costly fall category was category 1 - noninjurious, which accounted for 30% of falls and a 1-year cost of $US319 per event (range $US71-550). The least common and most costly was fall category 9 - multiple injuries, which accounted for 1% of falls and a 1-year cost of $US22 368 (range $US9969-64 382). Conclusions: The falls taxonomy represents a unique approach to estimating the cost of nursing home falls and offers a tool for evaluating the cost-effectiveness of fall prevention strategies. A validation study should be performed to confirm the magnitude of fall frequency and cost estimates.
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U2 - 10.2165/00002512-200623030-00007
DO - 10.2165/00002512-200623030-00007
M3 - Article
C2 - 16608380
AN - SCOPUS:33645783997
VL - 23
SP - 251
EP - 262
JO - Drugs and Aging
JF - Drugs and Aging
SN - 1170-229X
IS - 3
ER -