Post-hospital Falls in Older Patients: Investigating Associated Factors in Domain of Hospitalization and Subsequent Care

Abstract

<p>Background and Objectives: Post-hospital falls pose a significant healthcare burden for older adults, but the contributing factors related to hospitalization and subsequent care remain inadequately explored. This impedes the development of effective intervention strategies. Therefore, this study aimed to investigate the novel factors associated with post-hospital falls in domains of hospitalization and subsequent care.</p><p>Methods: This territory-wide retrospective cohort study examined the electronic medical records of patients aged 65 or over and discharged from public hospitals in Hong Kong in 2007-2018. Post-discharge falls within 12 months were identified through diagnosis codes or clinical notes from inpatient admission episodes, the Accident and Emergency Department visits, and death records. Binary logistic regression was employed to investigate the factors related to hospitalization and subsequent care that were associated with post-hospital falls, controlling for factors from biological and socioeconomic domains.</p><p>Results: Among 606,392 older patients, 28,593 (4.71%, 95% CI: 4.66%-4.77%) experienced falls within 12 months after discharge. Factors related to hospitalization and subsequent care, including discharge from non-surgical wards, length of stay over two weeks, and participation in Geriatric Day Hospital and Rehabilitation Day Program, were significantly associated with an increased risk of post-hospital falls (range of ORs: 1.07-1.52). Conversely, receiving Allied Health Service or Nurse Service was significantly correlated with a reduced risk (range of ORs: 0.60-0.71). Meanwhile, advancing age, being female, having more comorbidities, taking more Fall Risk Increasing Drugs, previous admission for falls, and living in Hong Kong Island were significantly associated with increased risk (range of ORs: 1.04-2.58).</p><p>Conclusions: The identified novel factors in domains of hospitalization and subsequent care further complete the profile of vulnerable group for post-hospital falls. It is crucial to prioritize fall risk assessments and implement tailored preventive measures for this specific group to reduce their risk of post-discharge falls.</p>