Can the provision of a minor 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

• BackgroundFall-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.   MethodsA 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 hospitalizations in the treatment population, the age of which varied by municipality (≥65 years, ≥67 years, ≥70 years or ≥75 years).ResultsWe found no statistically significant reductions in injury incidence in the panel regression (IRR 1.01 [95% CI: 0.98-1.05]) or RD (IRR 1.00 [95% CI: 0.97-1.03]) analyses. The results are robust to several different model specifications, including segmented panel regression analysis with linear trend change and community fixed effects parameters.ConclusionsIt 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 programs.

Subject headings

MEDICIN OCH HÄLSOVETENSKAP  -- Hälsovetenskap -- Folkhälsovetenskap, global hälsa, socialmedicin och epidemiologi (hsv//swe)

MEDICAL AND HEALTH SCIENCES  -- Health Sciences -- Public Health, Global Health, Social Medicine and Epidemiology (hsv//eng)

Keyword

falls

injury prevention

quasi-experiment

time series analysis

econometric analysis

Risk- och Miljöstudier

Risk and Environmental Studies

Public Health Science

Folkhälsovetenskap

Publication and Content Type

ref (subject category)

art (subject category)