The Contribution Falls Have to Increasing Risk of Nursing Home Placement in Community-Dwelling Older Adults

Abstract

To determine whether a fall, as an adverse event in combination with other risk factors, influences nursing home placement (NHP). A retrospective longitudinal study of 6,515 high-risk, community-dwelling, dually eligible (Medicare/Medicaid) participants in a waiver program during 2002-2007 are examined. Data are obtained from the Minimum Data Set-Home Care linked with Medicaid claim files. The authors fit multiple factors to a logistic curve, using generalized linear modeling to predict increased risk of NHP when a fall occurred. Prior NHP and an increased rate of falls (Odds Ratio [OR] = 1.52, 95% Confidence Interval [CI] = 1.25-1.84) and prior NHP and the same rate of falls (OR = 1.55, 95% CI = 1.26-1.91) both increased NHP. An adverse event such as a fall and prior NHP is a strong predictor of future NHP and should be taken into consideration while developing care plans for community-dwelling older adults.