158104 Annual, Statewide Hospital Charges for the Acute Care of Fall Related Injury

Monday, November 5, 2007

Jeannie Limpert, BS , School of Medicine, The George Washington University, Washington, DC
Mary Pat McKay, MD, MPH , School of Medicine, The George Washington University, Washington, DC
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.

Learning Objectives:
1. Describe the economics of fall related injury. 2. Discuss the implications for state policy of fall related injury. 3. List three ways charges for fall related injury differ from other ED and hospital visits.

Keywords: Epidemiology, Economic Analysis

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