Incidence and costs of falls and fall injuries among elderly in institutional care

Objective - To investigate the incidence and costs of falls among the elderly in institutional care. Design - A prospective study during the course of I year. Setting - Four institutions in Finland. Subjects - A total of 554 falls and 211 fall injuries among patients over 60 years of age. Main outcome measures - Falls and fall injuries were recorded prospectively. Treatment and the costs of injuries were analysed retrospectively. The incidence of falls and fall injuries was expressed per 1000 person years. Costs of fall injuries treated outside the patient's own ward were calculated. Results - The total incidence of falls was 1398/1000 person years. The incidence of fractures per 1000 person years was 54 (95% CI; 25-83) in women and 10 (95% Cl; 1-54) in men. Women fell on their hips or buttocks more often than men did (p < 0.01), Incidence of head injuries per 1000 person years was 214 (95% Cl; 160-267) in women and 433 (95%, Cl; 302-565) in men. The average costs were Euro 944 per fall. Conclusion - One-third of all falls resulted in an injury and every fifth injurious fall resulted in treatment outside the patient's own ward. The type of fall and the injury profile differed between men and women.