EFFECT OF THE POST FALL INDEX ON DEVICE AND EQUIPMENT COSTS FOR FALLS PREVENTION

摘要

Interventions for fall prevention must consider facility costs for purchasing durable medical equipment (DME), especially since items are expensive, possibly non- reimbursable or ineffective in falls prevention. The purpose of this study was to monetize the aggregate costs for DME used for fall care for one nursing home of elderly fallers pre- and post-intervention. The evidenced-based intervention (the Post Fall Index [PFI]) was a comprehensive post fall assessment and decision support tool used by trained nurses facility wide for one year to determine the likely fall diagnosis and appropriate interventions. The intervention was effective in reducing total and recurrent falls (32% and 25% respectively (p<.001). A count of the number and type of total DME’s utilized pre-intervention by the facility was aggregated by facility administration while electronic records entered by nurses using the PFI captured the number of new DME utilized. In the pre-intervention year, the facility spent $58,106.00 for 145 devices (assistive, surveillance, injury protection) among others, to manage 286 falls. Ten percent (n=15) of these 145 devices were considered reimbursable DME. After use of the PFI for one year, the facility spent $5,203.00 of which 14.4 percent (n=32) were for new purchases of DME interventions (surveillance) to manage 207 falls. The fall rate reduction of 79 falls following the use of the PFI was accompanied by what appears to be a reduced purchase of DME and increased utilization of nursing interventions. Findings suggest potential cost savings to facilities which invest in the infrastructure of improving nursing care delivery.