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Research Objectives
To investigate if quality indicator (QI) codes are associated with patient falls in
inpatient rehabilitation facilities (IRFs).
Design
In this retrospective cohort study, we collected data from the medical records of
1700 patients.
Setting
With the authorization of an institutional review board, we extracted data from 4
Utah IRFs.
Participants
We included the medical records of all patients over 14 years of age who were admitted
and discharged from these facilities in 2020.
Interventions
All patients were discharged prior to data extraction, so no interventions beyond
standard care were delivered. Items extracted include age, sex, race/ethnicity, diagnosis,
fall status, Morse Fall Scale score, and QI codes for understanding, self-care, and
mobility performance.
Main Outcome Measures
We calculated means, standard deviations, confidence intervals, and statistical differences
between those who fell and those who did not. We explored associations between QI
codes and falls using multivariaable logistic regression analysis.
Results
Medical records revealed 97 (5.71%) patients fell during IRF admission. Quality indicator
codes for patient understanding, self-care, and mobility performance were significantly
different between patients who fell and those who did not. A multivariable logistic
regression model showed that low performance with understanding, walking 10 feet,
and toileting was significantly associated with falls. Having an admission QI code
below 4 for understanding increased patients’ odds of falling by an estimated 78%.
Admission QI codes below 3 for walking 10 feet and toileting indicated over 2 times
greater odds of falling. Diagnosis, age, sex, and race/ethnicity were not significantly
associated with falls.
Conclusions
Quality indicator codes for understanding, self-care, and mobility are significantly
associated with falls. Further research should explore how these required codes may
be used to identify patients likely to fall during admission.
Author(s) Disclosures
The authors have no conflicts of interest to disclose.
Keywords
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Copyright
© 2022 Published by Elsevier Inc.
