Department of Physiotherapy, Aafje Nursing Homes, Rotterdam, The Netherlands.
Department of Public Health, Erasmus University Medical Center, Rotterdam, The Netherlands.
J Clin Nurs. 2018 Jul;27(13-14):2896-2903. doi: 10.1111/jocn.14488. Epub 2018 May 28.
To estimate the increased care demand and medical costs caused by falls in nursing homes.
There is compelling evidence that falls in nursing homes are preventable. However, proper implementation of evidence-based guidelines to prevent falls is often hindered by insufficient management support, staff time and funding.
A three-round Delphi study.
A panel of 41 experts, all working in nursing homes in the Netherlands, received three online questionnaires to estimate the extra hours of care needed during the first year after the fall. This was estimated for ten falls categories with different levels of injury severity, in three scenarios, that is a best-case, a typical-case and a worst-case scenario. We calculated the costs of falls by multiplying the mean amount of extra hours that the participants spent on the care for a resident after a fall with their hourly wages.
In case of a noninjurious fall, the extra time spent on the faller is on average almost 5 hr, expressed in euros that add to € 193. The extra staff time and costs of falls increased with increasing severity of injury. In the case of a fracture of the lower limb, the extra staff time increased to 132 hr, expressed in euros that is € 4,604. In the worst-case scenario of a fracture of the lower limb, the extra staff time increased to 284 hr, expressed in euros that is € 10,170.
Falls in nursing homes result in a great deal of extra staff time spent on care, with extra costs varying between € 193 for a noninjurious fall and € 10,170 for serious falls.
This study could aid decision-making on investing in appropriate implementation of falls prevention interventions in nursing homes.
评估养老院跌倒导致的护理需求增加和医疗费用。
有确凿的证据表明，养老院的跌倒事件是可以预防的。然而，由于管理支持、员工时间和资金不足，适当实施预防跌倒的循证指南常常受到阻碍。
三轮德尔菲研究。
一个由 41 名专家组成的小组，均在荷兰的养老院工作，他们收到了三份在线问卷，以评估跌倒后第一年需要额外护理的时间。这是根据不同严重程度的十种跌倒类别进行估计的，有三种情况，即最佳情况、典型情况和最坏情况。我们通过将参与者在跌倒后照顾居民的平均额外时间乘以他们的小时工资，计算出跌倒的成本。
在非伤害性跌倒的情况下，平均额外花费近 5 小时的时间来照顾跌倒者，以欧元计算则增加了 193 欧元。随着伤害严重程度的增加，额外的员工时间和跌倒成本也会增加。在下肢骨折的情况下，额外的员工时间增加到 132 小时，以欧元计算则为 4604 欧元。在下肢骨折的最坏情况下，额外的员工时间增加到 284 小时，以欧元计算则为 10170 欧元。
养老院的跌倒导致大量额外的护理时间，额外的成本从非伤害性跌倒的 193 欧元到严重跌倒的 10170 欧元不等。
本研究可以为在养老院投资适当实施跌倒预防干预措施的决策提供帮助。
