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Study protocol for investigating the impact of community home modification services on hospital utilisation for fall injuries: a controlled longitudinal study using data linkage.

ABSTRACT: INTRODUCTION:This study will evaluate the effectiveness of home adaptations, both in preventing hospital admissions due to falls for older people, and improving timely discharge. Results will provide evidence for services at the interface between health and social care, informing policies seeking to promote healthy ageing through prudent healthcare and fall prevention. METHODS AND ANALYSIS:All individuals living in Wales, UK, aged 60 years and over, will be included in the study using anonymised linked data from the Secure Anonymised Information Linkage Databank. We will use a national database of home modifications implemented by the charity organisation Care & Repair Cymru (C&R) from 2009 to 2017 to define an intervention cohort. We will use the electronic Frailty Index to assign individual levels of frailty (fit, mild, moderate or severe) and use these to create a comparator group (non-C&R) of people who have not received a C&R intervention. Coprimary outcomes will be quarterly numbers of emergency hospital admissions attributed to falls at home, and the associated length of stay. Secondary outcomes include the time in moving to a care home following a fall, and the indicative financial costs of care for individuals who had a fall. We will use appropriate multilevel generalised linear models to analyse the number of hospital admissions related to falls. We will use Cox proportional hazard models to compare the length of stay for fall-related hospital admissions and the time in moving to a care home between the C&R and non-C&R cohorts. We will assess the impact per frailty group, correct for population migration and adjust for confounding variables. Indicative costs will be calculated using financial codes for individual-level hospital stays. Results will provide evidence for services at the interface between health and social care, informing policies seeking to promote healthy ageing through prudent healthcare and prevention. ETHICS AND DISSEMINATION:Information governance requirements for the use of record-linked data have been approved and only anonymised data will be used in our analysis. Our results will be submitted for publication in peer-reviewed journals. We will also work with lay members and the knowledge transfer team at Swansea University to create communication and dissemination materials on key findings.

SUBMITTER: Hollinghurst J

PROVIDER: S-EPMC6224723 | biostudies-other | 2018 Oct

REPOSITORIES: biostudies-other

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Study protocol for investigating the impact of community home modification services on hospital utilisation for fall injuries: a controlled longitudinal study using data linkage.

Hollinghurst Joe J Akbari Ashley A Fry Richard R Watkins Alan A Berridge Damon D Clegg Andy A Hillcoat-Nalletamby Sarah S Williams Neil N Lyons Ronan R Mizen Amy A Walters Angharad A Johnson Rhodri R Rodgers Sarah S

BMJ open 20181030 10

<h4>Introduction</h4>This study will evaluate the effectiveness of home adaptations, both in preventing hospital admissions due to falls for older people, and improving timely discharge. Results will provide evidence for services at the interface between health and social care, informing policies seeking to promote healthy ageing through prudent healthcare and fall prevention.<h4>Methods and analysis</h4>All individuals living in Wales, UK, aged 60 years and over, will be included in the study u ...[more]

PMID: 30381314

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Project description:ObjectiveThis study aimed to investigate the pattern of general practice services utilization for Australian children and to examine socio-demographic disparities in general practitioner (GP) visits.MethodsWe used the linked data from the nationally representative Longitudinal Study of Australian Children (LSAC) and the Medicare Australia claims data record. We used survey negative binomial and logistic regression to examine the socio-demographic factors associated with the utilisation of general practice services.ResultsThe average number of annual GP visits gradually declined from 7.0 at 0-1 year old to 2.4 at 5-8 years (p< .001 for trend) in the infant cohort and from 3.5 at 2-4 years to 2.0 at 9-12 years (p < .001 for trend) in the child cohort. Girls were more likely to visit GPs than boys at 0-1 year old in the infant cohort (RR = 1.06, 95%CI: 1.02-1.11) and at 2-4 years in the child cohort (RR = 1.09, 95%CI: 1.04-1.14), but there were no differences at 2-4 to 5-8 year age periods in the infant cohort and at 5-8 to 9-12 year age period in the child cohort. Children from non-English speaking background were more likely to have a greater number of GP visits compared with their counterparts from English-speaking and Indigenous background up to eight year old in both cohorts (all p < .001). Children from families with the higher socio-economic position, children without private health insurance and children living in non-metropolitan were less likely to have GP consultations in both cohorts. Fair or poor parent-rated health status was associated with greater number of GP visits.ConclusionSocio-demographic disparities existed in the utilisation of general practice services and varied at different age periods. Family socio-economic position, private health insurance coverage and region of residence strongly associates with the utilisation disparities over all age period. Further policy interventions are called to minimise the disparities in GP utilisation for children in Australian context.

Dataset Information

Study protocol for investigating the impact of community home modification services on hospital utilisation for fall injuries: a controlled longitudinal study using data linkage.

Publications

Study protocol for investigating the impact of community home modification services on hospital utilisation for fall injuries: a controlled longitudinal study using data linkage.

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