TY  - JOUR
PY  - 2016//
TI  - Can the provision of a home help service for the elderly population reduce the incidence of fall-related injuries? A quasi-experimental study of the community-level effects on hospital admissions in Swedish municipalities
JO  - Injury prevention
A1  - Bonander, Carl M.
A1  - Gustavsson, Johanna
A1  - Nilson, Finn
SP  - 412
EP  - 419
VL  - 22
IS  - 6
N2  - BACKGROUND: Fall-related injuries are a global public health problem, especially in elderly populations. The effect of an intervention aimed at reducing the risk of falls in the homes of community-dwelling elderly persons was evaluated. The intervention mainly involves the performance of complicated tasks and hazards assessment by a trained assessor, and has been adopted gradually over the last decade by 191 of 290 Swedish municipalities. <br><br>METHODS: A quasi-experimental design was used where intention-to-treat effect estimates were derived using panel regression analysis and a regression discontinuity (RD) design. The outcome measure was the incidence of fall-related hospitalisations in the treatment population, the age of which varied by municipality (≥65 years, ≥67 years, ≥70 years or ≥75 years). <br><br>RESULTS: We found no statistically significant reductions in injury incidence in the panel regression (IRR 1.01 (95% CI 0.98 to 1.05)) or RD (IRR 1.00 (95% CI 0.97 to 1.03)) analyses. The results are robust to several different model specifications, including segmented panel regression analysis with linear trend change and community fixed effects parameters. <br><br>CONCLUSIONS: It is unclear whether the absence of an effect is due to a low efficacy of the services provided, or a result of low adherence. Additional studies of the effects on other quality-of-life measures are recommended before conclusions are drawn regarding the cost-effectiveness of the provision of home help service programmes.<br><br>Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/<p />  <p>Language: en</p>
LA  - en
SN  - 1353-8047
UR  - http://dx.doi.org/10.1136/injuryprev-2015-041848
ID  - ref1
ER  -