Although hospital falls have been decreasing over the past several years, they remain a significant problem. Patient falls are the most common adverse events reported in hospitals. Each year, roughly 700,000 to 1 million patient falls occur in U.S. hospitals resulting in around 250,000 injuries and up to 11,000 deaths. About 2% of hospitalized patients fall at least once during their stay. Approximately one in four falls result in injury, with about 10% resulting in serious injury.
Inpatient falls result in significant physical and economic burdens to patients (increased injury and mortality rates and decreased quality of life) as well as to medical organizations (increased lengths of stay, medical care costs, and litigation). In 2008, Centers for Medicare & Medicaid Services (CMS) stopped reimbursing hospitals for fall-related injuries.
Hospitals employ various guidelines for fall prevention. In general these include: 1) identify patients who are at high risk of falling and 2) use clinical judgment to decide which of a multitude of fall prevention strategies to utilize to reduce fall risk. Not surprisingly, there is considerable heterogeneity among the guidelines which adds to confusion on the “right approach” to fall prevention; this is promoting the uptake of time- and labor- intensive approaches to fall prevention into “standard of care.” The lack of clarity of prevention guidelines may add to the cognitive burden of patient care and potentially increases patient risk.
In the United States, over 14 million, or one in four, adults ages 65 and older (older adults), report falling each year. While not all falls result in an injury, about 37% of those who fall reported an injury that required medical treatment or restricted their activity for at least one day, resulting in an estimated nine million fall injuries.
Falls are the leading cause of injury-related death among adults ages 65 and older, and the fall death rate is increasing. The age-adjusted fall death rate increased by 41% from 55.3 per 100,000 older adults in 2012 to 78.0 per 100,000 older adults in 2021.
Falls among adults aged 65 and older are common, costly, and preventable. Falls are the leading cause of fatal and nonfatal injuries among older adults.
Among all adult patients, a history of previous fall was the most commonly reported risk factor for falls followed by sensory impairment (vision, hearing, balance, etc.). Among all Falls, ambulating without assistance and without an assistive device, toileting, and ambulating with assistance and/or with an assistive device were the most common patient activities before the falls. For all 243,449 reported fall Incidents, 7,523 (3.1%) indicated injury and residual harm to the patient, and 30,741 (12.6%) indicated no injury and no residual harm to the patient. Among these 7,523 records, 484 (6.4%) indicated that activity prior to the fall was ambulating with assistance; from the 30,741 records, 2,166 records (7.0%) indicated that activity prior to the fall was ambulating with assistance.
If you or a family member were injured (or worse) as a result of a fall in a hospital in the United States, you should promptly find a medical malpractice attorney in your state who may investigate your hospital fall claim for you and represent you or your family member in a hospital fall case, if appropriate.
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