Doctors warn: Non-payment for patient falls could lead to increased use of restraints

Share this content:
New regulations that stop payments to hospitals for treatment after potentially preventable patient falls could backfire, leading instead to increased use of restraints, a Harvard Medical School physician and colleagues are warning.

Increased pressure from regulators could lead some caregivers to use restraints in order to prevent falls, possibly leading to increased instances of bedsores, breathing problems or delirium, which, ironically, can lead to an increased risk of falls, writes Dr. Sharon Inouye in an opinion piece in the New England Journal of Medicine. Even under ideal conditions, as many as one in five patients will experience a fall during a hospital stay, asserts Inouye, director of the Aging Brain Center at the Institute for Aging Research at Hebrew Senior Life in Boston. Because of their inevitable nature, falls should be removed from the list of avoidable medical errors for which hospitals will not receive reimbursement, Inouye argues.

The Centers for Medicare & Medicaid Services declared such falls as non-reimbursable events in response to a 2005 survey from the Institute of Medicine. The survey found that patients in hospitals acquired an alarming rate of potentially deadly conditions. Inouye's article appeared in Thursday's issue of the NEJM.