Fall-related injuries are a leading diagnoses for hospital readmissions, particularly for at-risk older adults discharged home. There is a need for greater attention to transitional prevention strategies to avoid post-discharge falls.

Falls were the leading reason for readmission among patients whose initial hospital was fall-related and who were discharged to home, even with home health care.

A 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 and the second-leading diagnosis at readmission for patients with cognitive impairment and whose initial hospitalization was fall-related.

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.

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.

Among patients initially hospitalized with a fall-related injury who were discharged home or to home healthcare, a repeat fall-related injury ranked as the leading cause of readmission (12.3% and 11.8% respectively).

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).

Proper education is key, said senior author Lillian Min, U-M associate professor of geriatrics and palliative medicine. “Discharge planners, doctors, patients and families should develop a personalized plan to balance increased mobility and fall prevention,” she said. This can include community-based interventions, home modifications and education.

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