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Health technology assessment for preventing patient falls in hospitals
  1. A K D Nielsen*
  1. Correspondence Odense University Hospital, Sdr. Boulevard 29, indgang 101, 3. sal, Denmark

Abstract

Background Patient falls are frequent and costly in terms of both financial and personal costs, and account for 10% of the reported adverse events.

Methods The Danish HTA approach includes an evaluation of the prerequisites for and consequences of implementing health technology. The evaluation covers technologies, patients perspectives, organisational aspects and economic evaluation. Technologies included both risk assessment tools (RAT) and fall preventive interventions. A systematic literature search was carried out in 13 international databases including Pubmed, Cochrane, Embase, Cinahl, Psychinfo etc.

Results The literature did not present evidence that RAT were effective in distinguishing between fallers and non-fallers. One systematic review found evidence of a possible 18% reduction in risk of falls when interventions were multiple, that is, included several interventions. There was a limited amount of literature concerning patients perspectives and organisational aspects of fall prevention in hospitals. Also, the topics in patient- and organisational literature did not focus on the interventions that were identified as effective. Hospital costs were estimated based on the literature. Preventing a fall was estimated to cost approximately 7000. The average price of a patient fall from a hospital perspective was 400.

Conclusions Based on the systematic literature search for this HTA, it is recommended to implement multiple interventions for fall prevention. It is important, to include monitoring of local effectiveness along with assessments of patients preferences, organisational prerequisites and economic consequences of introducing multiple interventions for fall prevention.

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