Citation

Bonander CM, Gustavsson J, Nilson F. Inj. Prev. 2016; 22(6): 412-419.

Affiliation

Division of Risk Management, Department of Environmental and Life Sciences, Karlstad University, Sweden Centre for Public Safety, Karlstad University, Karlstad, Sweden.

Copyright

(Copyright © 2016, BMJ Publishing Group)

DOI

10.1136/injuryprev-2015-041848

PMID

27016460

Abstract

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.

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).

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.

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.

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Language: en