The impact of community-based interventions for the older population: a quasi-experimental study of a hip-fracture prevention program in Norway

BMC Geriatr. 2018 Dec 13;18(1):311. doi: 10.1186/s12877-018-1004-z.

Abstract

Background: Hip fractures among older adults are a major public health problem in many countries. Hip fractures are associated with expensive health care treatments, and serious adverse effects on patients' health and quality-of-life. In this paper, we estimate the effect of a community-based hip fracture prevention program that was initiated in 16 Norwegian municipalities in 2007. Specifically, the participating municipalities implemented one or more of the following interventions: exercise programs for older adults, information and education campaigns to communicate how to effectively reduce falls to care workers and older adults, and preventive home safety assessment and modification help services.

Methods: We used a difference-in-difference design, and identified control municipalities by matching on pre-intervention trends in the outcome. The outcome measure was the incidence of hip-fractures among older adults (≥65 years).

Results: We found no statistically significant effects of the implemented program on the incidence of hip fractures, on average, in older subgroups (≥80 years) or in municipality-specific analyses.

Conclusions: It is unclear whether the interventions managed to achieve a change in hip fracture rates at the population level.

Keywords: Community interventions; Difference-in-differences; Hip fracture; Matching; Natural experiments.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Accidental Falls / prevention & control*
  • Aged
  • Aged, 80 and over
  • Community Health Services
  • Exercise
  • Female
  • Hip Fractures / epidemiology
  • Hip Fractures / prevention & control*
  • Humans
  • Incidence
  • Male
  • Middle Aged
  • Norway
  • Outcome Assessment, Health Care
  • Patient Education as Topic
  • Quality of Life