The Cost of Serious Fall-Related Injuries at Three Midwestern Hospitals
The Cost of Serious Fall-Related Injuries at Three Midwestern Hospitals
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DOI：
10.1016/s1553-7250(11)37010-9
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发表时间：
2011-02-01
影响因子：
2.3
通讯作者：
Dunagan, Wm. Claiborne
中科院分区：
文献类型：
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作者：
Wong, Catherine A.;Recktenwald, Angela J.;Dunagan, Wm. Claiborne
背景：与跌倒相关的伤害的后果可能会造成身体和经济上的代价，但如果没有最新的数据，医院无法完全确定财务成本。方法：在一项回顾性病例对照研究中，57名在2004年1月1日至2006年10月16日期间出院的严重跌倒相关损伤(骨折、硬膜下血肿、任何导致手术干预或死亡的伤害)的住院患者通过事故报告系统被确定，并按医院、五年内的年龄、出院年份、结果：多因素分析显示，与对照组相比，严重损伤组的手术费用增加了13,316美元(p<；01；95%可信区间[CI]，1,395-35,561美元)，下跌的人比没有下跌的人多停留6.3天(p<；.001；95%CI，2.4-14.9)。单变量分析表明，他们也明显更有可能患有糖尿病合并器官损害、中到重度肾脏疾病，以及Charlson共病指数的平均得分更高。在最优二部匹配(OBM)分析中，严重跌倒患者的住院费用比非跌倒患者多13,806美元(P<；.001；95%CI，5,808-29,450美元)，住院时间延长6.9天(P<；.001；95%CI，2.8-14.9)。结论：与非跌倒患者相比，严重跌倒相关伤害住院患者的总手术成本更高，住院时间更长。尽管成本分配方法可能存在局限性，但分析包括来自三家不同医院的数据，对学术医院状况进行调整的补充多变量分析并不会对结果产生有意义的影响。
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.