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

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.

Keywords: Bayesian; Connecticut Collaboration for Fall Prevention; fall-related traumatic brain injury; hospitalization; spatial model.