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The Economics of Preventing Hospital Falls

Demonstrating ROI Through a Simple Model

Spetz, Joanne PhD, FAAN; Brown, Diane S. PhD, RN, CPHQ, FNAHQ, FAAN; Aydin, Carolyn PhD

JONA: The Journal of Nursing Administration: January 2015 - Volume 45 - Issue 1 - p 50–57
doi: 10.1097/NNA.0000000000000154

OBJECTIVE: The objective of this study was to assess the cost savings associated with implementing nursing approaches to prevent in-hospital falls.

BACKGROUND: Hospital rating programs often report fall rates, and performance-based payment systems force hospitals to bear the costs of treating patients after falls. Some interventions have been demonstrated as effective for falls prevention.

METHODS: Costs of falls-prevention programs, financial savings associated with in-hospital falls reduction, and achievable fall rate improvement are measured using published literature. Net costs are calculated for implementing a falls-prevention program as compared with not making improvements in patient fall rates.

RESULTS: Falls-prevention programs can reduce the cost of treatment, but in many scenarios, the costs of falls-prevention programs were greater than potential cost savings.

CONCLUSIONS: Falls-prevention programs need to be carefully targeted to patients at greatest risk in order to achieve cost savings.

Author Affiliations: Professor (Dr Spetz), Philip R. Lee Institute for Health Policy Studies & Center for the Health Professions, University of California, San Francisco; Executive Director for Cost Improvement Strategy (Dr Brown), Kaiser Permanente Northern California, Oakland, and Senior Scientist (Dr Brown), Collaborative Alliance for Nursing Outcomes (CALNOC), San Ramon, California; and Research Scientist, Cedars-Sinai Medical Center and Burns & Allen Research Institute, Los Angeles; and DataManagement Services Director (Dr Aydin), CALNOC, San Ramon, California.

This intramural research was funded by CALNOC.

The authors declare no conflicts of interest.

Correspondence: Dr Spetz, Philip R. Lee Institute for Health Policy Studies, 3333 California St, Ste 265, San Francisco, CA 94118 (

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