Online Program

Calculating Rates of Fall Injuries Using Present on Admission Indicators in the State Inpatient Database

Monday, November 2, 2015

Oluwafolakemi Adedeji, PhD, MS, Oklahoma Clinical & Translational Sciences Institute, University of Oklahoma Health Science Center, Oklahoma City, OK
Background/Purpose:With the implementation of the Present on Admission Indicator Reporting policy by the Centers for Medicare and Medicaid Services in 2007, hospitals began reporting Present on Admission Indicators in State Inpatient Databases in 2008. This change allowed fall injuries which were not present at the time of a patient's admission to be identified and quantified. Currently, little is known about the magnitude of such fall injuries in acute care hospitals.

Methods: Using State Inpatient Datasets from Arizona, New Jersey and Washington States,  Present on Admission Indicators N and U representing diagnosis not present on admission and insufficient documentation to determine diagnosis at admission respectively were combined with ICD-9 diagnoses codes for fall injuries to create vector variables. Then from the vector variables, frequencies and rates of fall injuries per 1000 Medicare admissions were calculated.

Results/Outcomes: Across the three states a total of 874 fall injuries were found after admission yielding a rate of 0.97 fall injuries per 1000 Medicare admissions.

Conclusions: The magnitude of fall injuries across the three states is relatively small. Subsequent research should be conducted to see if the low numbers are related to the non-payment policy implemented alongside the Present on Admission Indicator Reporting policy.

Learning Areas:

Administration, management, leadership

Learning Objectives:
Identify fall injuries which were not present in patients at the time of their admission Analyze the rates of fall injuries per 1000 adult Medicare admission records Explain plausible reasons for study findings

Keyword(s): Data Collection and Surveillance, Medicare

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: This research was part of my dissertation work for my PhD degree obtained from the Univ of Texas School of Public Health. I was the principal investigator for this study. I was responsible for manipulating inpatient hospital databases from Arizona, New Jersey and Washington states. I analyzed these data in SPSS to calculate the rates of specific fall injuries defined by CMS under the Hospital Acquired Conditions and Present on Admission Indicator Reporting Program .
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.