T E Murphy1, M E Tinetti, H G Allore. 1. Department of Internal Medicine, Yale University School of Medicine, New Haven, CT, USA. terrence.murphy@yale.edu
Abstract
BACKGROUND AND OBJECTIVE: Evidence-based second stage translational studies are necessary and difficult to evaluate. A quasi-experimental design is used to compare the rate of fall-related health care utilization of two geographically disparate areas in Connecticut, a small state in the northeastern United States, to evaluate an intervention designed to reduce fall-related injuries among older persons. This evaluation examines the two years immediately prior to intervention. METHODS: The experimental units are postal (i.e., zip) code tabulation areas (ZCTAs) in which counts of fall-related health care utilization and demographic characteristics can be gathered from local and federal public health sources. We employ hierarchical modeling to determine whether there was a difference in fall-related health care utilization between the study arms prior to initiating the intervention. Geographic information systems are used to characterize neighboring ZCTAs and to graph model-adjusted rates of fall-related utilization. RESULTS: After adjustment for covariates and spatial variation, we observed no significant difference between rates or temporal trends of fall-related health care utilization in the study arms over the two year pre-intervention period. CONCLUSION: The study arms of the Connecticut Collaboration for Falls Prevention have equivalent rates and temporal trends of fall-related utilization over the two year pre-intervention period.
BACKGROUND AND OBJECTIVE: Evidence-based second stage translational studies are necessary and difficult to evaluate. A quasi-experimental design is used to compare the rate of fall-related health care utilization of two geographically disparate areas in Connecticut, a small state in the northeastern United States, to evaluate an intervention designed to reduce fall-related injuries among older persons. This evaluation examines the two years immediately prior to intervention. METHODS: The experimental units are postal (i.e., zip) code tabulation areas (ZCTAs) in which counts of fall-related health care utilization and demographic characteristics can be gathered from local and federal public health sources. We employ hierarchical modeling to determine whether there was a difference in fall-related health care utilization between the study arms prior to initiating the intervention. Geographic information systems are used to characterize neighboring ZCTAs and to graph model-adjusted rates of fall-related utilization. RESULTS: After adjustment for covariates and spatial variation, we observed no significant difference between rates or temporal trends of fall-related health care utilization in the study arms over the two year pre-intervention period. CONCLUSION: The study arms of the Connecticut Collaboration for Falls Prevention have equivalent rates and temporal trends of fall-related utilization over the two year pre-intervention period.
Authors: Nancy S Sung; William F Crowley; Myron Genel; Patricia Salber; Lewis Sandy; Louis M Sherwood; Stephen B Johnson; Veronica Catanese; Hugh Tilson; Kenneth Getz; Elaine L Larson; David Scheinberg; E Albert Reece; Harold Slavkin; Adrian Dobs; Jack Grebb; Rick A Martinez; Allan Korn; David Rimoin Journal: JAMA Date: 2003-03-12 Impact factor: 56.272
Authors: M E Tinetti; D I Baker; G McAvay; E B Claus; P Garrett; M Gottschalk; M L Koch; K Trainor; R I Horwitz Journal: N Engl J Med Date: 1994-09-29 Impact factor: 91.245
Authors: Terrence E Murphy; Dorothy I Baker; Linda S Leo-Summers; Luann Bianco; Margaret Gottschalk; Denise Acampora; Mary B King Journal: Gerontologist Date: 2012-10-04
Authors: Mary E Tinetti; Dorothy I Baker; Mary King; Margaret Gottschalk; Terrence E Murphy; Denise Acampora; Bradley P Carlin; Linda Leo-Summers; Heather G Allore Journal: N Engl J Med Date: 2008-07-17 Impact factor: 91.245
Authors: Terrence E Murphy; Dorothy I Baker; Linda S Leo-Summers; Heather G Allore; Mary E Tinetti Journal: J Am Geriatr Soc Date: 2013-09-19 Impact factor: 5.562