Cost per fall: a potentially misleading indicator of burden of disease in health and residential care settings

Haines, Terry P., Nitz, Jenny, Grieve, Julia, Barker, Anna, Moore, Kirsten, Hill, Keith, Haralambous, Betty and Robinson, Andrew (2013) Cost per fall: a potentially misleading indicator of burden of disease in health and residential care settings. Journal of Evaluation in Clinical Practice, 19 1: 153-161. doi:10.1111/j.1365-2753.2011.01786.x

Author Haines, Terry P.
Nitz, Jenny
Grieve, Julia
Barker, Anna
Moore, Kirsten
Hill, Keith
Haralambous, Betty
Robinson, Andrew
Title Cost per fall: a potentially misleading indicator of burden of disease in health and residential care settings
Journal name Journal of Evaluation in Clinical Practice   Check publisher's open access policy
ISSN 1356-1294
Publication date 2013-02
Year available 2011
Sub-type Article (original research)
DOI 10.1111/j.1365-2753.2011.01786.x
Volume 19
Issue 1
Start page 153
End page 161
Total pages 9
Place of publication Chichester, West Sussex, United Kingdom
Publisher Wiley-Blackwell Publishing
Collection year 2014
Language eng
Formatted abstract
Rationale Little scrutiny has been applied to how ‘cost per fall’ values have been calculated and applied. This paper presents discourse discussing how the cost of fall statistic could potentially be misleading when applied to inpatient health or residential care settings and provides estimates of the cost of falls and cost of falls per person.
Method Burden of disease was estimated using a decision tree approach. Data informing the decision tree were drawn from a retrospective audit of 545 falls in a residential care facility, a visual observation study of 46 residents from the same facility and a cohort study of 186 residents from nine different facilities in Australia. Acute care and transportation costs were extracted from the retrospective audit using incident reports and care note review. The distribution of falls per person and associations between falls, fractures and change in resident mobility were extracted from the cohort study. The association between resident mobility and the amount of time required to perform toileting, transfer and dressing activities was extracted from the visual observational study.
Results The minimum ‘cost per fall’ was estimated to be $AUD 841 and the maximum was $AUD 1024. The ‘cost of falls per person’ estimate was $AUD 1887 (2008 base year).
Conclusions This cost per fall estimate was substantially lower than three previous internationally derived estimates possibly as a consequence of how fall data were collected and modelled in these studies. Cost of falls per person may be a preferable statistic for future use.
Keyword Cost of illness
Older adult
In-hospital falls
Q-Index Code C1
Q-Index Status Confirmed Code
Institutional Status UQ
Additional Notes Published online 26 october 2011

Document type: Journal Article
Sub-type: Article (original research)
Collections: Official 2014 Collection
School of Health and Rehabilitation Sciences Publications
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