|
Epidemiology of Falls and Analysis of Direct Hospital Costs: Findings from a Study in Northern Iran
|
Behzad Zohrevandi1    , Kayvan Hajipour2 , Saeed Azadkhah2 , Seyyed Mahdi Zia Ziabari3 , Ali Davoudi Kiakalayeh4 , Naema Khodadadi- Hassankiadeh *5 |
1- Guilan University of Medical Sciences & Department of Emergency Medicine, Guilan Road Trauma Research Center, Trauma Institute, Guilan University of Medical Sciences, Rasht, Iran., Guilan university of medical sciences
2- Guilan University of Medical Sciences & School of Medicine, Guilan University of Medical Sciences, Rasht, Iran., Guilan university of medical sciences
3- Guilan University of Medical Sciences & Department of Emergency Medicine, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran., Guilan university of medical sciences
4- Guilan University of Medical Sciences & Department of Preventive and Community Medicine, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran., Guilan university of medical sciences
5- Guilan University of Medical Sciences & Determinants of Health Research Center, Trauma Institute, Guilan University of Medical Sciences, Rasht, Iran., Guilan university of medical sciences , n_khodadady@yahoo.com |
|
|
Abstract: (238 Views) |
Background: Epidemiological studies on falls, particularly those considering direct hospital costs, are limited. Therefore, this study aimed to determine the risk factors, complications, and direct hospital costs associated with falls in northern Iran.
methods: In this descriptive study using secondary data analysis, all medical records of fall-related injuries from April 2011 to March 2015 were included through a census method. Relevant variables were extracted from the hospital information system (HIS). Data were analyzed using SPSS version 21, and a p-value of less than 0.05 was considered statistically significant.
Results: A total of 13,126 patients were included, with a mean age of 37.91 ± 0.42 years and a mean hospital stay of 2.92 ± 0.028 days. Overall, 0.4% of patients died. The mean cost per patient was 3,053,514.96 ± 61,097.102 IRR. Patients who fell at home were significantly older than those who fell outside the home, and the mean age of patients with fall-related complications was significantly higher (p<0.001). Men were significantly more likely to experience falls outside the home (p<0.001). Patients who fell during dusk or nighttime were significantly younger than those who fell during the day, and the mean cost per recovered patient was significantly lower than for deceased patients.
Conclusion: The findings indicate that age, gender, location, and time of fall are associated with injury severity and economic outcomes. Based on these results, fall-prevention programs should be targeted, focusing on older women at home and young men in outdoor activities to enhance the effectiveness of preventive strategies. |
|
| Keywords: Falling, risk factor, Injury, Emergency, Trauma, Cost |
|
|
Full-Text [PDF 764 kb]
(9 Downloads)
|
Type of Study: Original |
Subject:
General
Received: 2025/07/9 | Accepted: 2025/10/21 | Published: 2025/12/31
|
|
|
|
|
|
|
| References |
1. Rodrigues F, Domingos C, Monteiro D, Morouço P. A review on aging, sarcopenia, falls, and resistance training in community-dwelling older adults. International journal of environmental research and public health. 2022;19(2):874. [ DOI:10.3390/ijerph19020874] [ PMID] [ ] 2. Fikadu A, Sultan M, Michael M, Workina A. Pattern and outcomes of fall injuries and associated factors in emergency department at Addis Ababa Burn, Emergency and Trauma Hospital. Open access emergency medicine. 2021:381-9. [ DOI:10.2147/OAEM.S315546] [ PMID] [ ] 3. Jehu D, Davis J, Falck R, Bennett K, Tai D, Souza M, et al. Risk factors for recurrent falls in older adults: A systematic review with meta-analysis. Maturitas. 2021;144:23-8. [ DOI:10.1016/j.maturitas.2020.10.021] [ PMID] 4. Dykes PC, Curtin-Bowen M, Lipsitz S, Franz C, Adelman J, Adkison L, et al., editors. Cost of inpatient falls and cost-benefit analysis of implementation of an evidence-based fall prevention program. JAMA Health Forum; 2023: American Medical Association. [ DOI:10.1001/jamahealthforum.2022.5125] [ PMID] [ ] 5. Heinrich S, Rapp K, Rissmann U, Becker C, König H-H. Cost of falls in old age: a systematic review. Osteoporosis international. 2010;21:891-902. [ DOI:10.1007/s00198-009-1100-1] [ PMID] 6. Lee J, Negm A, Peters R, Wong EK, Holbrook A. Deprescribing fall-risk increasing drugs (FRIDs) for the prevention of falls and fall-related complications: a systematic review and meta-analysis. BMJ open. 2021;11(2):e035978. [ DOI:10.1136/bmjopen-2019-035978] [ PMID] [ ] 7. Kwon J, Lee Y, Young T, Squires H, Harris J. Qualitative research to inform economic modelling: a case study in older people's views on implementing the NICE falls prevention guideline. BMC health services research. 2021;21:1-19. [ DOI:10.1186/s12913-021-07056-1] [ PMID] [ ] 8. Lewis SR, McGarrigle L, Pritchard MW, Bosco A, Yang Y, Gluchowski A, et al. Population‐based interventions for preventing falls and fall‐related injuries in older people. Cochrane database of systematic reviews. 2024(1). [ DOI:10.1002/14651858.CD013789.pub2] [ PMID] [ ] 9. Dsouza SA, Rajashekar B, Dsouza H, Kumar K. Falls in Indian older adults: a barrier to active ageing. Asian J Gerontol Geriatr. 2014;9(1):1-8. 10. Reider L, Falvey JR, Okoye SM, Wolff JL, Levy JF. Cost of US emergency department and inpatient visits for fall injuries in older adults. Injury. 2024;55(2):111199. [ DOI:10.1016/j.injury.2023.111199] [ PMID] [ ] 11. Na'emani F, Esmaiil Zali M, Sohrabi Z, Fayaz-Bakhsh A. Prevalence of risk factors for falls among the elderly receiving care at home. Iranian Journal of Ageing. 2019;13(5):638-51. [ DOI:10.32598/SIJA.13.Special-Issue.638] 12. Mortazavi H, Tabatabaeichehr M, Taherpour M, Masoumi M. Relationship between home safety and prevalence of falls and fear of falling among elderly people: a cross-sectional study. Materia socio-medica. 2018;30(2):103. [ DOI:10.5455/msm.2018.30.103-107] [ PMID] [ ] 13. Queirós AM, von Gunten A, Amoussou JR, Martins MM, Verloo H. Relationship between depression and falls among nursing home residents: protocol for an integrative review. JMIR research protocols. 2023;12(1):e46995. [ DOI:10.2196/46995] [ PMID] [ ] 14. İleri İ, Borazan FY, Cavusoglu C, Göker B. The relationship between the severity of insomnia and falls in the elderly. Psychogeriatrics. 2022;22(1):22-8. [ DOI:10.1111/psyg.12767] [ PMID] 15. Nascimento MdM, Gouveia ÉR, Gouveia BR, Marques A, França C, Freitas DL, et al. Exploring mediation effects of gait speed, body balance, and falls in the relationship between physical activity and health-related quality of life in vulnerable older adults. International journal of environmental research and public health. 2022;19(21):14135. [ DOI:10.3390/ijerph192114135] [ PMID] [ ] 16. Zhang H, Zhao Y, Wei F, Han M, Chen J, Peng S, et al. Prevalence and Risk Factors for Fall among Rural Elderly: A County‐Based Cross‐Sectional Survey. International journal of clinical practice. 2022;2022(1):8042915. [ DOI:10.1155/2022/8042915] [ PMID] [ ] 17. Lee S. Falls associated with indoor and outdoor environmental hazards among community-dwelling older adults between men and women. BMC geriatrics. 2021;21:1-12. [ DOI:10.1186/s12877-021-02499-x] [ PMID] [ ] 18. Chantanachai T, Taylor ME, Lord SR, Menant J, Delbaere K, Sachdev PS, et al. Risk factors for falls in community-dwelling older people with mild cognitive impairment: a prospective one-year study. PeerJ. 2022;10:e13484. [ DOI:10.7717/peerj.13484] [ PMID] [ ] 19. Hopkins J, Hill K, Jacques A, Burton E. Prevalence, risk factors and effectiveness of falls prevention interventions for adults living with Mild Cognitive Impairment in the community: A systematic review and meta-analysis. Clinical rehabilitation. 2023;37(2):215-43. [ DOI:10.1177/02692155221129832] [ PMID] 20. Altuhaifa F, Al Tuhaifa D, Al Ribh E, Al Rebh E. Identifying and defining entities associated with fall risk factors events found in fall risk assessment tools. Computer Methods and Programs in Biomedicine Update. 2023;3:100105. [ DOI:10.1016/j.cmpbup.2023.100105] 21. Dautzenberg L, Beglinger S, Tsokani S, Zevgiti S, Raijmann RC, Rodondi N, et al. Interventions for preventing falls and fall‐related fractures in community‐dwelling older adults: A systematic review and network meta‐analysis. Journal of the American Geriatrics Society. 2021;69(10):2973-84. [ DOI:10.1111/jgs.17375] [ PMID] [ ] 22. Cao Z, Zhu C, Zhou Y, Wang Y, Chen M, Ju Y, et al. Risk factors related balance disorder for patients with dizziness/vertigo. BMC neurology. 2021;21(1):186. [ DOI:10.1186/s12883-021-02188-7] [ PMID] [ ] 23. Ghosh M, O'Connell B, Afrifa-Yamoah E, Kitchen S, Coventry L. A retrospective cohort study of factors associated with severity of falls in hospital patients. Scientific reports. 2022;12(1):12266. [ DOI:10.1038/s41598-022-16403-z] [ PMID] [ ] 24. Zhao YL, Bott M, He J, Kim H, Park SH, Dunton N. Multilevel factors associated with injurious falls in acute care hospitals. Journal of nursing care quality. 2018;33(1):20-8. [ DOI:10.1097/NCQ.0000000000000253] [ PMID] 25. Hatamabadi H RA, Alavi Moghaddam M, Sum S. A Study on Consequences of Fall Among Elderly People Referred to Emam Hossein Hospital in Tehran City During 2010-2011. Salmand: 26. . Iranian Journal of Ageing 2014; 9 (1) :55-62.9(1):55-62. 27. Hacıdursunoğlu Erbaş D, Çınar F, Eti Aslan F. Elderly patients and falls: a systematic review and meta-analysis. Aging clinical and experimental research. 2021:1-14. [ DOI:10.1007/s40520-021-01843-w] [ PMID] 28. Moreland BL, Kakara R, Haddad YK, Shakya I, Bergen G. A descriptive analysis of location of older adult falls that resulted in emergency department visits in the United States, 2015. American journal of lifestyle medicine. 2021;15(6):590-7. [ DOI:10.1177/1559827620942187] [ PMID] [ ] 29. Valipoor S, Pati D, Kazem-Zadeh M, Mihandoust S, Mohammadigorji S. Falls in older adults: a systematic review of literature on interior-scale elements of the built environment. Journal of aging and environment. 2020;34(4):351-74. [ DOI:10.1080/02763893.2019.1683672] 30. Coltrane S. Research on household labor: Modeling and measuring the social embeddedness of routine family work. Journal of Marriage and family. 2000;62(4):1208-33. [ DOI:10.1111/j.1741-3737.2000.01208.x] 31. Emad Y, Neef SP, Taylor L, Kerse N, Cavadino A, Moyes SA, et al. Shedding Light on Falls: The Effect of Lighting Levels on Fall Risk in Long-Term Residential Care Facilities. Journal of Applied Gerontology. 2024:07334648241302552. [ DOI:10.1177/07334648241302552] [ PMID] [ ] 32. Montero-Odasso M, Van Der Velde N, Martin FC, Petrovic M, Tan MP, Ryg J, et al. World guidelines for falls prevention and management for older adults: a global initiative. Age and ageing. 2022;51(9):afac205. 33. McHugh MD, Aiken LH, Sloane DM, Windsor C, Douglas C, Yates P. Effects of nurse-to-patient ratio legislation on nurse staffing and patient mortality, readmissions, and length of stay: a prospective study in a panel of hospitals. The Lancet. 2021;397(10288):1905-13. [ DOI:10.1016/S0140-6736(21)00768-6] [ PMID] 34. Kayser SA, Koloms K, Murray A, Khawar W, Gray M. Incontinence and incontinence-associated dermatitis in acute care: a retrospective analysis of total cost of care and patient outcomes from the premier healthcare database. Journal of Wound Ostomy & Continence Nursing. 2021;48(6):545-52. [ DOI:10.1097/WON.0000000000000818] [ PMID] [ ] |
|
| Send email to the article author |
|
|
|
| Add your comments about this article |
|
|
|
|
Clinical trials code: 0
Zohrevandi B, Hajipour K, Azadkhah S, Zia Ziabari S M, Davoudi Kiakalayeh A, Khodadadi- Hassankiadeh N. (2025). Epidemiology of Falls and Analysis of Direct Hospital Costs: Findings from a Study in Northern Iran. Health Res Develop. 3(4), 79-89.
URL: http://jhrd.trjums.ac.ir/article-1-120-en.html
|
