Falls: An examination of three reporting methods in nursing homes

D. N. Kanten, C. D. Mulrow, M. B. Gerety, Michael J Lichtenstein, Christine Aguilar, J. E. Cornell

Research output: Contribution to journalArticle

60 Citations (Scopus)

Abstract

Objective: To examine the concordance of various fall reporting methods and to use the results to recommend a preferred method of ascertaining fall frequency for residents of nursing homes, both for research and in the collection of federally mandated nursing home data. Design: A cohort study followed for 858 patient months, with a mean individual follow-up of 6.6 months. Measurements: Falls were independently ascertained monthly by three methods: review of administrative incident reports, nursing home chart abstraction, and structured interview of subjects. Concordance of events was assessed using measures of simple agreement and Kendall's Tau-b. Simple correlation and multiple regression were used to evaluate the relation of age, sex, gender, depression, mental status, and functional status with degree of concordance between self-reported falls and chart-recorded falls. Setting: One academic and six community nursing homes in San Antonio, Texas. Participants: 131 long-stay nursing home residents, greater than 60 years of age, dependent in at least two activities of daily living, and mildly cognitively impaired. Results: Falls were ascertained in 74 of the 131 individuals; 53 subjects fell 124 times by incident report, 58 had 140 falls according to chart review, and 66 subjects self-reported 232 falls. Greatest agreement between reporting methods was shown for incident report and chart review, with a Kendall's Tau-b of 0.88; self-report and chart-review agreement was 0.56; and self-report and incident agreement was 0.53. Estimated total fall events were more often (P = 0.001) identified by chart review (92%) than incident report (82%). Although concordance was higher for non-fallers, no significant relationships were observed between concordance and age, sex, race, depression, mental status, and functional status. Also, there was no systematic relationship between length of follow-up and degree of concordance. Conclusions: Fall frequency varies by ascertainment method, with chart review reflecting a greater number of fall events than the traditionally counted incident reports.

Original languageEnglish (US)
Pages (from-to)662-666
Number of pages5
JournalJournal of the American Geriatrics Society
Volume41
Issue number6
StatePublished - 1993

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Nursing Homes
Self Report
Activities of Daily Living
Cohort Studies
Interviews
Research

ASJC Scopus subject areas

  • Geriatrics and Gerontology

Cite this

Kanten, D. N., Mulrow, C. D., Gerety, M. B., Lichtenstein, M. J., Aguilar, C., & Cornell, J. E. (1993). Falls: An examination of three reporting methods in nursing homes. Journal of the American Geriatrics Society, 41(6), 662-666.

Falls : An examination of three reporting methods in nursing homes. / Kanten, D. N.; Mulrow, C. D.; Gerety, M. B.; Lichtenstein, Michael J; Aguilar, Christine; Cornell, J. E.

In: Journal of the American Geriatrics Society, Vol. 41, No. 6, 1993, p. 662-666.

Research output: Contribution to journalArticle

Kanten, DN, Mulrow, CD, Gerety, MB, Lichtenstein, MJ, Aguilar, C & Cornell, JE 1993, 'Falls: An examination of three reporting methods in nursing homes', Journal of the American Geriatrics Society, vol. 41, no. 6, pp. 662-666.
Kanten, D. N. ; Mulrow, C. D. ; Gerety, M. B. ; Lichtenstein, Michael J ; Aguilar, Christine ; Cornell, J. E. / Falls : An examination of three reporting methods in nursing homes. In: Journal of the American Geriatrics Society. 1993 ; Vol. 41, No. 6. pp. 662-666.
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