Analysis of potential cost reductions related to falls in hospitalized elderly patients by correcting high-dose prescriptions of sedative hypnotics

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Abstract

Background:

Risk factors for falls include older age, diseases, and certain medications. High-dose sedative hypnotics have been shown to increase the risk of falls, necessitating caution when these medications are used. High-dose sedative hypnotics have an increased half-life in elderly patients with reduced hepatic and renal function, which may increase fall risk.

Methods:

This retrospective survey evaluated the potential cost reductions associated with fall prevention by changing high-dose prescriptions. For this purpose, the association between falls and high-dose usage of sedative hypnotics was analyzed in hospitalized elderly patients. Study participants were 267 ambulatory patients aged ≥65 years who were taking sedative hypnotics and were hospitalized for ≥3 days from May 2012 to April 2013 at the Gifu Municipal Hospital, Japan. Patients' age, sex and usage of sedative hypnotics (high-dose vs. non-highdose) were analyzed, as well as the costs incurred by tests, drugs, and wages for medical personnel for patients on high-dose sedative hypnotics who experienced falls.

Results:

Analysis revealed a significantly higher rate of falls in the group using high-dose sedative hypnotics (21.4%; 14/224) compared to the non-high-dose group (6.3%; 9/42, p=0.004). Assessment of cost demonstrated potential savings of ¥589 per case if falls could be prevented by correcting high-dose prescriptions.

Conclusions:

This study indicates that high-dose prescriptions of sedative hypnotics may be associated with fall risk in the elderly. Correcting high-dose prescriptions for these drugs would be beneficial not only for medical safety, but also the medical economy.

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