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Measuring the Direct Healthcare Costs of a Fall Injury Event

Findorff, Mary J.; Wyman, Jean F.; Nyman , John A.; Croghan, Catherine F.

doi: 10.1097/01.NNR.0000280613.90694.b2

Background: Falls are a leading cause of injury in older adults. Obtaining cost data for a randomized controlled trial aimed at preventing falls was problematic, and an approach was needed to obtain these data on a relatively small sample of women who used healthcare services.

Approach: The study population was 272 community-dwelling women aged 70 and over who were participants in a fall prevention trial. Fall incident reports and billing records were used to obtain costs associated with outpatient visits, emergency department visits, acute care hospitalizations, nursing home stays, home healthcare visits, rehabilitation visits, and ambulance use. Average time and costs for obtaining fall-related healthcare cost data also were estimated.

Results: The mean age of those with falls requiring healthcare utilization was 78.9 years (SD = 5.1 years). Billing records were obtained for 47 of 55 injurious falls (85%). Costs ranged from $63 to $85,984, with a mean cost of $6,606 and a median cost of $658 per fall-related injurious event. The average time it took to collect the data was just over 5 hr per fall, with an estimated data collection cost of $170 per fall.

Discussion: The mean cost of falls was higher than seen in other studies, although methods differ. Collecting cost data related to a specific fall injury event directly from study participants was feasible, practical, and relatively inexpensive. Direct costs of injurious falls are greater than have been estimated in previous studies.

Mary J. Findorff, PhD, MPH, RN, is Research Associate; Jean F. Wyman, PhD, RN, is Professor and Cora Meidl Siehl Chair in Nursing Research; and Catherine F. Croghan, MS, MPH, RN, is Research Nurse, Center for Gerontological Nursing, School of Nursing; and John A. Nyman, PhD, is Professor, Division of Health Policy and Management, School of Public Health, University of Minnesota, Minneapolis.

Accepted for publication March 5, 2007.

This research was funded by the National Institute of Nursing Research and the Office of Research on Women's Health, National Institutes of Health (R01 NR05107).

Thank you to Melinda Monigold, Carrie Gomez, Lois Gildea, and Kristine Talley for their contributions in the collection of data, and thank you to the study participants for their cooperation and commitment to the study.

© 2007 Lippincott Williams & Wilkins, Inc.