# Type of Wheelchair Used before Nursing Home Admission and Fall-Related Fractures after Nursing Home Admission

## TL;DR

This study finds that older adults who used multifunctional wheelchairs before entering a nursing home had more fall-related fractures than those who used standard wheelchairs.

## Contribution

The study provides preliminary evidence linking pre-admission wheelchair type to post-admission fall-related fractures.

## Key findings

- Five fall-related fractures occurred among multifunctional wheelchair users.
- No fractures were observed among standard wheelchair users.
- Multifunctional wheelchair users had higher fracture incidence after nursing home admission.

## Abstract

Residents who use multifunctional wheelchairs before nursing home admission often face discontinuation of such devices after nursing home admission. However, basic data on this issue remain limited. Therefore, in this study, we aimed to provide preliminary data by investigating the occurrence of fall-related fractures after nursing home admission, stratified by the type of wheelchair used before nursing home admission.

We used linked long-term care claims data, care-need certification survey data, and medical claims data from Ibaraki Prefecture, Japan. Participants were older adults who were newly admitted to nursing homes directly from home between July 2018 and February 2019 and had used wheelchair rental services before nursing home admission. We divided the wheelchairs into two types using long-term care claims data: multifunctional and standard wheelchairs. The outcomes of interest were newly occurring fall-related fractures within the first month of nursing home admission, identified from medical claims data. Fracture incidence was compared between the two wheelchair types, and information of residents with fracture were described.

The study included 215 participants. The participants’ median age was 88 years (interquartile range, 83-93); 153 (71.2%) were female, and 96 (44.7%) used a multifunctional wheelchair before nursing home admission. There are no fall-related fractures occurred among standard wheelchair users, whereas five fractures were observed among multifunctional wheelchair users.

Residents who used multifunctional wheelchairs experienced more fall-related fractures after admission than those who used standard wheelchairs before nursing home admission. Further research is needed to better understand the issue of service continuity by investigating wheelchair use after nursing home admission and the circumstances of fall-related fractures.