Hospital-at-Home Patient Fall Predictors

Area of Science:

• Gerontology
• Healthcare Management
• Patient Safety

Background:

• Hospital-at-home (HaH) care offers an alternative to traditional inpatient settings.
• Falls are a significant safety concern in healthcare, including HaH environments.
• Identifying predictors of falls is essential for developing effective prevention strategies.

Purpose of the Study:

• To identify predictors of falls among patients receiving hospital-at-home care.
• To evaluate the association of various patient characteristics with fall risk in the HaH setting.

Main Methods:

• Retrospective study of HaH patients across three US states (Florida, Wisconsin, Arizona) from July 2020 to July 2023.
• Matched 51 fallers with 153 non-fallers.
• Collected data on demographics, comorbidities (Charlson Comorbidity Index), polypharmacy, and oxygen use; analyzed using logistic regression.

Main Results:

• The fall rate was 6.8 per 1,000 patient bed-days.
• Independent predictors of falls included older age (OR 1.37 per 10-year increase), higher Charlson Comorbidity Index (OR 1.80 per 5-unit increase), and supplemental oxygen use (OR 2.05).
• A trend towards increased falls was noted in patients with respiratory disorders (OR 2.07).

Conclusions:

• Older age, elevated Charlson Comorbidity Index, and supplemental oxygen use are associated with increased fall risk in HaH patients.
• These findings highlight the need for tailored fall prevention interventions in home-based hospital care.
• Further research into respiratory disorders as a fall risk factor is warranted.