Prevalence and cost of imaging in inpatient falls: the rising cost of falling

Figures & data

Table 1 Characteristics of 530 inpatients who fell from 2008 to 2010 during stay at Tufts Medical Center

Characteristics	N=530 (%)
Age (mean age =60.7)
18–44	87 (16)
45–64	220 (42)
>65	223 (42)
Sex
Male	294 (55)
Female	236 (45)
Admitting service
Medicine	307 (58)
Surgery	80 (15)
Obstetrics/gynecology	14 (3)
Psychiatry	63 (12)
Neurological	66 (12)
Time/shift of fall
Morning (7 am–3 pm)	176 (33)
Evening (3 pm–11 pm)	179 (34)
Night (11 pm–7 am)	175 (33)
Fall risk assessment (Morse Fall Scale)
Positive	298 (56)
Negative	153 (29)
Missing	79 (15)

Table 2 Characteristics of 178 patients who were imaged and 352 patients not imaged after a fall from 2008 to 2010 during hospital stay

Characteristics	Imaged n=178 (34%)	Not imaged n=352 (66%)	P-value (Pearson’s chi-squared test)
Age
18–44	26 (30)	61 (70)	0.23
45–64	68 (30)	152 (70)
>65	84 (37)	139 (63)
Mean	62.6 years	59.7 years	0.07
Sex
Male	99 (34)	195 (66)	0.96
Female	79 (33)	157 (67)
Admitting service
Medicine	119 (39)	188 (61)	0.02
Surgery	15 (19)	65 (81)
Obstetrics/gynecology	4 (28)	10 (72)
Psychiatry	19 (30)	44 (70)
Neurological	21 (32)	45 (68)
Time/shift of fall
Morning (7 am–3 pm)	48 (27)	128 (73)	0.09
Evening (3 pm–11 pm)	67 (37)	112 (63)
Night (11 pm–7 am)	63 (36)	112 (64)
Fall risk assessment (Morse Fall Scale)
High fall risk	103 (35)	195 (65)	0.41
Low fall risk	47 (30)	106 (70)
Missing	28 (35)	51 (65)

Table 3 Characteristics of 178 patients imaged after an inpatient fall from 2008 to 2010 comparing those with positive (35) to those with negative studies (143)

Characteristics	Negative study n=143 (80%)	Positive study n=35 (20%)	P-value
Age (mean 61)
18–44	24 (92)	2 (8)	0.13
45–64	51 (75)	17 (25)
>65	68 (80)	16 (20)
Mean	62.6	62.5
Sex
Male	79 (79)	20 (21)	0.84
Female	64 (81)	15 (19)
Admitting service
Medicine	98 (82)	21 (18)	0.84
Surgery	11 (73)	4 (27)
Obstetrics/gynecology	3 (75)	1 (25)
Psychiatry	14 (74)	5 (26)
Neurological	17 (81)	4 (19)
Time/shift of fall
Morning (7 am–3 pm)	36 (75)	12 (25)	0.40
Evening (3 pm–11 pm)	57 (85)	10 (15)
Night (11 pm–7 am)	50 (79)	13 (21)
Fall risk assessment (Morse Fall Scale)
Positive	85 (82)	18 (18)	0.69
Negative	40 (85)	7 (15)
Missing	18 (64)	10 (36)

Table 4 Cost of imaging by type, cost per positive imaging study

Studies ordered 2008–2010	Cost per study (average)	Total done N (%)	Negative N (%)	Positive N (%)	Total cost (%)	Cost per positive ($)
Head CT	$662.50	152 (58)	129 (85)	23 (15)	$100,700 (63)	$4,378.26
Other CT	$1,013.03	37 (14)	26 (70)	11 (30)	$37,482 (23)	$3,407.45
X-ray	$193.89	65 (25)	54 (83)	11 (17)	$12,603 (8)	$1,145.73
MRI	$1,264	8 (3)	5 (63)	3 (37)	$10,112 (6)	$3,370.67
Totals		262	214 (82)	48 (18)	$160,897	$3,352.02

Abbreviations: CT, computed tomography; MRI, magnetic resonance imaging.