Association between treatment or usual care region and hospitalization for fall-related traumatic brain injury in the Connecticut Collaboration for Fall Prevention

康涅狄格州防跌倒协作研究中,治疗或常规护理区域与跌倒相关创伤性脑损伤住院治疗之间的关联

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Abstract

OBJECTIVES: To evaluate the association between the treatment region (TR) or usual care region (UCR) of the Connecticut Collaboration for Fall Prevention (CCFP), a clinical intervention for prevention of falls, and the rate of hospitalization for fall-related traumatic brain injury (FR-TBI) in persons aged 70 and older and to describe the Medicare charges for FR-TBI hospitalizations. DESIGN: Using a quasi-experimental design, rates of hospitalization for FR-TBI were recorded over an 8-year period (2000-2007) in two distinct geographic regions (TR and UCR) chosen for their similarity in characteristics associated with occurrence of falls. SETTING: Two geographical regions in Connecticut. PARTICIPANTS: More than 200,000 persons aged 70 and older. INTERVENTION: Clinicians in the TR translated research protocols from the Yale Frailty and Injuries: Cooperative Studies of Intervention Techniques, a successful fall-prevention randomized clinical trial, into discipline- and site-specific fall-prevention procedures for integration into their clinical practices. MEASUREMENTS: Rate of hospitalization for FR-TBI in persons aged 70 and older. RESULTS: Connecticut Collaboration for Fall Prevention's TR exhibited lower rates of hospitalization for FR-TBI than the UCR (risk ratio = 0.84, 95% credible interval = 0.72-0.99). CONCLUSION: The significantly lower rate of hospitalization for FR-TBI in CCFP's TR suggests that the engagement of practicing clinicians in the implementation of evidence-based fall-prevention practices may reduce hospitalizations for FR-TBI.

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