Annual, Statewide Hospital Charges for the Acute Care of Fall Related Injury

Purpose: Describe the economics of fall injuries. Methods: Health Care Utilization Project data (state census of billing data from acute care, non-federal hospitals) was analyzed. Only Nebraska met study entry criteria: available data with better than 95% E-coding for both emergency department (ED)-only visits and inpatients. E-codes 880-888 defined falls. SPSS v14.0 calculated chi-squared or ANOVA as appropriate. Results: 30,711 of 332,602 ED-only visits had fallen (9.2%) with charges totaling $25,228,133 (8.7%). Mean charges for ED falls were less than non-falls ($822 vs. $867, p<0.001) and the patients were older than non-falls (p<0.001). Medicare ED falls patients were older and charged less than other Medicare ED patients (p<0.05). Of the 181,588 hospital admissions, 6,333 were falls (3.5%), with charges totaling $130,714,943 (4%). Mean charges for falls were higher than for non-injury visits ($20,460 vs $15,068, p<0.01). Falls had higher charges than non-falls except if the payer was Medicare, where charges were lower (p<0.05). Patients admitted for falls or other injuries were more likely to die while in the hospital than uninjured patients (3.1% vs. 1.9%, p<0.05). Falls survivors were more likely to be discharged to an inpatient source of care (55.3% vs. 12.8% non-falls, p <0.01). Conclusions: In Nebraska in 2004, fall injuries comprised $155, 943,076 in hospital charges; 4.4% of total statewide hospital charges. Fall injuries account for a disproportionate amount of hospital charges. If admitted, fall patients were much more likely to continue to require ongoing inpatient care.