Format

Send to

Choose Destination
See comment in PubMed Commons below
J Am Geriatr Soc. 2006 Jun;54(6):891-7.

Healthcare utilization of elderly persons hospitalized after a noninjurious fall in a Swiss academic medical center.

Author information

  • 1Service of Geriatric Medicine and Geriatric Rehabilitation, Department of Medicine, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland. Laurence.Seematter-Bagnoud@chuv.ch

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.

[PubMed - indexed for MEDLINE]
PubMed Commons home

PubMed Commons

0 comments
How to join PubMed Commons

    Supplemental Content

    Full text links

    Icon for Wiley
    Loading ...
    Write to the Help Desk