Yvonne A Johnston1, Gwen Bergen2, Michael Bauer3, Erin M Parker4, Leah Wentworth5, Mary McFadden6, Chelsea Reome6, Matthew Garnett3. 1. Master of Public Health Program, Binghamton University, New York. 2. National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, Georgia. 3. Bureau of Occupational Health and Injury Prevention, New York State Department of Health, Albany, New York. 4. US Public Health Service, Centers for Disease Control and Prevention, National Center for Injury Prevention and Control, Atlanta, Georgia. 5. System Administration, State University of New York (SUNY), Albany, New York. 6. Broome County Health Department, Binghamton, New York.
Abstract
BACKGROUND AND OBJECTIVES: Older adult falls pose a growing burden on the U.S. health care system. The Centers for Disease Control and Prevention's Stopping Elderly Accidents, Deaths, and Injuries (STEADI) initiative was developed as a multifactorial approach to fall prevention that includes screening for fall risk, assessing for modifiable risk factors, and prescribing evidence-based interventions to reduce fall risk. The purpose of this study was to determine the impact of a STEADI initiative on medically treated falls within a large health care system in Upstate New York. RESEARCH DESIGN AND METHODS: This cohort study classified older adults who were screened for fall risk into 3 groups: (a) At-risk and no Fall Plan of Care (FPOC), (b) At-risk with a FPOC, and (c) Not-at-risk. Poisson regression examined the group's effect on medically treated falls when controlling for other variables. The sample consisted of 12,346 adults age 65 or older who had a primary care visit at one of 14 outpatient clinics between September 11, 2012, and October 30, 2015. A medically treated fall was defined as a fall-related treat-and-release emergency department visit or hospitalization. RESULTS: Older adults at risk for fall with a FPOC were 0.6 times less likely to have a fall-related hospitalization than those without a FPOC (p = .041), and their postintervention odds were similar to those who were not at risk. DISCUSSION AND IMPLICATIONS: This study demonstrated that implementation of STEADI fall risk screening and prevention strategies among older adults in the primary care setting can reduce fall-related hospitalizations and may lower associated health care expenditures. Published by Oxford University Press on behalf of The Gerontological Society of America 2018.
BACKGROUND AND OBJECTIVES: Older adult falls pose a growing burden on the U.S. health care system. The Centers for Disease Control and Prevention's Stopping Elderly Accidents, Deaths, and Injuries (STEADI) initiative was developed as a multifactorial approach to fall prevention that includes screening for fall risk, assessing for modifiable risk factors, and prescribing evidence-based interventions to reduce fall risk. The purpose of this study was to determine the impact of a STEADI initiative on medically treated falls within a large health care system in Upstate New York. RESEARCH DESIGN AND METHODS: This cohort study classified older adults who were screened for fall risk into 3 groups: (a) At-risk and no Fall Plan of Care (FPOC), (b) At-risk with a FPOC, and (c) Not-at-risk. Poisson regression examined the group's effect on medically treated falls when controlling for other variables. The sample consisted of 12,346 adults age 65 or older who had a primary care visit at one of 14 outpatient clinics between September 11, 2012, and October 30, 2015. A medically treated fall was defined as a fall-related treat-and-release emergency department visit or hospitalization. RESULTS: Older adults at risk for fall with a FPOC were 0.6 times less likely to have a fall-related hospitalization than those without a FPOC (p = .041), and their postintervention odds were similar to those who were not at risk. DISCUSSION AND IMPLICATIONS: This study demonstrated that implementation of STEADI fall risk screening and prevention strategies among older adults in the primary care setting can reduce fall-related hospitalizations and may lower associated health care expenditures. Published by Oxford University Press on behalf of The Gerontological Society of America 2018.
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