Inj Prev 19:363 doi:10.1136/injuryprev-2012-040706
  • Study protocol

In-hospital falls and fall-related injuries: a protocol for a cost of fall study

  1. Johannes Stoelwinder1
  1. 1The Centre of Research Excellence in Patient Safety, Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
  2. 2Physiotherapy Department, Monash University and Allied Health Research Unit, Southern Health, Monash University, Melbourne, Victoria, Australia
  3. 3Centre for Health Economics, Monash University, Melbourne, Victoria, Australia
  4. 4School of Physiotherapy, Curtin University, Perth, Western Australia, Australia
  5. 5The George Institute for Global Health, The University of Sydney, Sydney, New South Wales, Australia
  6. 6The Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
  1. Correspondence to Renata Teresa Morello, Centre of Research Excellence in Patient (CRE-PS), School of Public Health and Preventive Medicine, Department of Epidemiology and Preventive Medicine, Monash University, Level 6, The Alfred Centre, 99 Commercial Road, Melbourne Victoria 3004, Australia; Renata.Morello{at}
  • Received 15 November 2012
  • Revised 15 November 2012
  • Accepted 21 November 2012
  • Published Online First 8 January 2013


Background In-hospital falls are common and pose significant economic burden on the healthcare system. To date, few studies have quantified the additional cost of hospitalisation associated with an in-hospital fall or fall-related injury. The aim of this study is to determine the additional length of stay and hospitalisation costs associated with in-hospital falls and fall-related injuries, from the acute hospital perspective.

Methods and design A multisite prospective study will be conducted as part of a larger falls-prevention clinical trial—the 6-PACK project. This study will involve 12 acute medical and surgical wards from six hospitals across Australia. Patient and admission characteristics, outcome and hospitalisation cost data will be prospectively collected on approximately 15 000 patients during the 15-month study period. A review of all in-hospital fall events will be conducted using a multimodal method (medical record review and daily verbal report from the nurse unit manager, triangulated with falls recorded in the hospital incident reporting and administrative database), to ensure complete case ascertainment. Hospital clinical costing data will be used to calculate patient-level hospitalisation costs incurred by a patient during their inpatient stay. Additional hospital and hospital resource utilisation costs attributable to in-hospital falls and fall-related injuries will be calculated using linear regression modelling, adjusting for a priori-defined potential confounding factors.

Discussion This protocol provides the detailed statement of the planned analysis. The results from this study will be used to support healthcare planning, policy making and allocation of funding relating to falls prevention within acute hospitals.

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