Attaining a 64% Reduction in Fall-Caused Hospitalizations among Community Resident Elders: Two Multifactorial Studies

摘要

Objective: The purpose of the studies reported here is: 1.) to evaluate the effectiveness of a multi-factorial, socio-medical fall prevention program among 1,894 community-resident elders in Philadelphia; 2.) to present the data from a replicative study among 1,053 identically selected and identically treated elders. Methods: In study #1, a random sample of Medicaid-eligible seniors, geographically representative of Philadelphia County’s dual-eligible, was selected using a geographic density procedure by zip code. Subjects participated in informational workshops, non-invasive somatic fall risk factor analysis, HIPPA compliant sharing of risk reports with physicians and pharmacists, in-home environmental fall risk analysis, pre- and post-fall counseling, and periodic safety grams. The treatment group was compared with two (2) large scale control groups for: a.) reduced hospitalizations for all injurious falls; and 2b) reduced hospitalization for fall-caused fractures. In study #2, 1,054 community-resident elders were selected via similar procedures and accorded to identical arrays of interventions. Results: In study #1, using Medicaid claims data, the treatment group was shown to have significantly fewer instances of healthcare utilization due to injurious falls compared to the control groups (p < 0.05): hospitalizations for fractures were 55% lower and hospitalizations for all fall-caused injuries were 65% lower. In study #2, participants who accepted all offered interventions were 400% less likely to suffer a self-reported fall than were non-participants. Conclusions: Multi-disciplinary, socio-medical fall prevention programs for community-resident elders can significantly reduce healthcare utilization due to injurious falls.