Fall-related injuries are a major reason why seniors are readmitted to the hospital within a month after being discharged, a new study finds. Little was known about the relationship between falls and hospital readmissions.

Three Key Facts About Falls and Readmissions

  • Fall-related injuries within a month of hospital discharge were the third-leading cause of readmission. The risk was higher among patients already considered to be at risk for falls, and those who were discharged to their homes or home healthcare.
  • Fall-related injuries were the second-leading reason for readmission among patients with mental impairment whose initial hospitalization was fall-related.
  • Falls were the leading reason for readmission among patients whose initial hospitalization was fall-related and who were discharged to home, even if they had home healthcare.

A new University of Michigan study found that in people 65 or older, fall-related injuries within a month of hospital discharge ranked as high as the third-leading diagnosis for readmission. The risk was greater for patients already deemed fall risks, or who were discharged to their homes or home healthcare.

The study came about after he and colleagues in a previous study interviewed patients and caregivers about fall prevention, hospital-to-home transition and fall risk awareness. They found that most respondents recalled receiving little fall prevention information at the hospital discharge, though all were considered fall risks.

 “Falls are a trifecta in terms of reasons why they need an increased focus,” said Hoffman, who also is a member of the U-M Institute for Healthcare Policy and Innovation. “They are highly prevalent, cause a lot of damage, including death, and they are preventable. However, fall prevention is being left out of the discharge planning conversation and that needs to change.”

Researchers examined 8.3 million patient readmissions using two years of Hospital Cost and Utilization Project Nationwide Readmissions data. They identified the frequency of fall-related readmissions overall and for two high-risk subgroups: those with cognitive impairment and those whose initial hospitalization was fall-related.

The overall readmission rate was 14 percent. It was a bit higher for those with cognitive impairment (16 percent), but a bit lower for those with a previous fall injury (13 percent).

Discharge Planning

The findings suggest that by emphasizing personalized fall prevention before discharge, especially for at-risk patients, hospitals could improve patients’ recovery and mobility, and minimize costly fall-related penalties, said principal investigator Geoffrey Hoffman, an assistant professor at the U-M School of Nursing.

“After discharge, the goal is to provide patient-centered fall prevention and to safely encourage patients to get up and move,” Hoffman said. “Previous research suggests that in the long-term, limited mobility can harm patients and increase fall risks, something many caregivers and patients may not realize, because sedentary behavior appears to reduce fall risks and falls in the shorter-term.”

Hoffman said that while the prevalence of fall-related readmissions is high, hospitals can use existing tools to reduce their frequency. Hospitals already know how to identify those with cognitive impairment and fall risk, and have improved their discharge procedures to avoid Medicare’s costly readmission penalty. Now, they just need to include fall prevention in that discharge discussion.

Source: Michigan News