Falls: An Examination of Three Reporting Methods in Nursing Homes

Deanna N. Kanten, Cynthia D. Mulrow, Meghan B. Gerety, Michael J Lichtenstein, Christine Aguilar, John E. Cornell

Research output: Contribution to journalArticlepeer-review

62 Scopus citations


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. 1993 The American Geriatrics Society

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

ASJC Scopus subject areas

  • Geriatrics and Gerontology


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