干预以预防跌倒：社区诊所。
Intervention to Prevent Falls: Community-Based Clinics.
机构信息
1 Yale University, New Haven, CT, USA.
2 VNA Community Healthcare, Guilford, CT, USA.
出版信息
J Appl Gerontol. 2019 Jul;38(7):999-1010. doi: 10.1177/0733464817721113. Epub 2017 Jul 22.
PURPOSE
The purpose of this study was to document results of State funded fall prevention clinics on rates of self-reported falls and fall-related use of health services.
METHODS
Older adults participated in community-based fall prevention clinics providing individual assessments, interventions, and referrals to collaborating community providers. A pre-post design compares self-reported 6-month fall history and fall-related use of health care before and after clinic attendance.
RESULTS
Participants ( N = 751) were predominantly female (82%) averaging 81 years of age reporting vision (75%) and mobility (57%) difficulties. Assessments revealed polypharmacy (54%), moderate- to high-risk mobility issues (39%), and postural hypotension (10%). Self-reported preclinic fall rates were 256/751(34%) and postclinic rates were 81/751 (10.8%), ( p = .0001). Reported use of fall-related health services, including hospitalization, was also significantly lower after intervention.
IMPLICATIONS
Evidence-based assessments, risk-reducing recommendations, and referrals that include convenient exercise opportunities may reduce falls and utilization of health care services. Estimates regarding health care spending and policy are presented.
目的
本研究旨在记录由州政府资助的防跌倒诊所的结果，这些结果反映在自我报告的跌倒率和与跌倒相关的卫生服务使用情况上。
方法
老年人参加了基于社区的防跌倒诊所，这些诊所提供了个人评估、干预和向合作社区提供者的转介。采用前后设计，比较了就诊前和就诊后 6 个月内自我报告的跌倒史和与跌倒相关的医疗保健使用情况。
结果
参与者（N=751）主要为女性（82%），平均年龄为 81 岁，报告存在视力（75%）和行动（57%）困难。评估显示存在多种药物治疗（54%）、中高度风险的行动问题（39%）和体位性低血压（10%）。自我报告的就诊前跌倒率为 256/751（34%），就诊后跌倒率为 81/751（10.8%），（p=0.0001）。干预后，与跌倒相关的健康服务（包括住院治疗）的报告使用率也显著降低。
影响
基于证据的评估、降低风险的建议和包括方便锻炼机会的转介，可能会降低跌倒率和医疗保健服务的使用。本文还提出了有关医疗保健支出和政策的估计。
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