Falls documented after personal emergency alarm call-outs in Iceland: 12-month frequency, causes, circumstances and consequences

Introduction: Responder-completed reports after personal emergency alarm call-outs can provide actionable information for fall prevention. This study aimed to assess 12-month fall frequency and describe causes, circumstances, and consequences among alarm users in Iceland, comparing users with and without documented falls.

Methods: A retrospective study of users with continuous alarm service for 12 months and reimbursement from Icelandic Health Insurance (N=765). Alarm-service and insurance data were linked to identify responder-documented falls (falls/year; ≥1; ≥2) and user characteristics (age group, sex, ICD-10 diagnoses). Group differences were assessed using appropriate non-parametric tests. Incident reports for users with documented falls (n=129) were coded using quantitative content analysis to classify causes, circumstances, and consequences. Security staff members were interviewed about their call-out experiences.

Results: Users were aged 23–100 years (mean 81.7±10.0), 73.7% were women, 96.9% lived in urban areas, and ICD-10 counts ranged 0–15 (mean 3.5±2.4). Overall, 457 falls were documented among 16.9% (129/765), and 54.3% (70/129) experienced recurrent falls (≥2 falls/year). Falls/year were higher in users aged <65 years than in those aged 75–84 (p=0.017) and ≥85 years (p=0.046), with no sex difference. Users with documented falls had a higher number of ICD-10 diagnoses than others (p=0.042). In incident reports, leading causal factors were medication use (41.2%) and environmental factors (23.5%). Falls occurred most often at night (35.1%) and in bedrooms (44.6%). Documented consequences included soft-tissue injury (42.6%) and musculoskeletal pain (32.4%); ambulance transport was documented in 6.6%. No significant differences in causal factors, circumstances, or consequences were found by sex or age group. Security staff offered reasoned ideas for improvements in their service.

Conclusion: Linked alarm-service and insurance data provide insight into responder-documented falls after call-outs in Iceland and can inform targeted prevention and service development. Strengthened routine documentation may improve care quality and research on falls at home.