Patient falls challenged as no-pay events

Patients come to hospitals because they're impaired, then are given drugs that while beneficial, may impair their judgment and balance further. This makes patient falls a difficult problem to address. In fact, despite strenuous efforts to curb the problem, up to one in five patients fall at least once during their hospital stay, which can raise hospital bills by as much as $4,000.

The thing is, with hospitals being penalized for "preventable" falls by Medicare, hospitals are under great pressure to force the issue--which could lead to greater harm through use of restraints, one doctor argues.

In a New England Journal of Medicine piece, Dr. Sharon Inouye of Harvard Medical School and co-authors contend that falls shouldn't be included on the list of no-pay events used by CMS, particularly given the lack of accepted guidelines on fall prevention.

Without such guidelines, patients can end up in restraints, which can make them agitated or delirious--both of which can lead to falls, as well. Research also suggests that restrained patients are more likely to develop bed sores, have trouble breathing, or even die.

To learn more about this research:
- read this piece from The Boston Globe

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