This short scoping report seeks to express the value of preventing falls that lead to harm.
The purpose is to inform where the Health Quality & Safety Commission New Zealand (the Commission) may best focus its efforts in reducing harm from falls, taking into account the roles and initiatives of stakeholders, and to point to areas for further analysis.
The Commission is naturally interested in inpatient falls because in 2010/11 these accounted for 195, or 52%, of the 377 reported serious and sentinel events in public hospitals. These events require significant additional treatment, are life threatening, or cause a major loss of function or death.1 The Commission reports that 88 of the 195 resulted in a fractured hip, reportedly costing hospitals more than $2m.
In addition, the number of serious and sentinel event falls had risen by about 50% each year between 2007/08 and 2010/11 (the latest data available when this report was prepared). It is not clear whether this trend is due to increased and improved reporting or changes in practice.
Apart from these hospital-based serious and sentinel event falls, falls also occur in other places, such as the home and aged residential care facilities. Other stakeholders have approaches to address harm from those falls, but the Commission also has an interest as these falls may relate to treatment and care practices and decisions.
The value proposition for reducing harm from falls is that it reduces the costs of treatment and rehabilitation, including premature admission to aged residential care. It also prevents premature loss of life or decrease in the quality of life.
Prevention programme costs would need to be compared to the costs they are likely to reduce or avoid in order to assess whether a programme is the best use of resources. However that task was outside scope.
This is an initial scoping report only. The aim is to provide an initial, broad order of magnitude estimate of the financial and human costs from falls.
The methods used in this report reflect this limited brief. The approach was to: briefly explore ACC claims data and National Minimum Dataset hospital discharge data; review a number of readily available local and international research reports on the topic; and interview a number of subject matter experts on their knowledge of the volume, cost and broader consequences of falls. These experts were identified by the Commission, and those mentioned in interviews undertaken.
This initial scoping report is not intended to provide in-depth data analysis and modelling or a full systematic review of the literature on the topic. This report also does not consider the costs or effectiveness of programmes aimed at reducing the harm from falls.