Centre for Health Economics and Policy Analysis, McMaster University, 1280 Main Street West, CRL-201, Hamilton, ON, L8S 4K1, Canada.
Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Canada.
BMC Geriatr. 2020 Feb 27;20(1):80. doi: 10.1186/s12877-020-1483-6.
Accidental falls among older adults are a leading cause of injury-related hospitalizations. Reducing falls is an ongoing quality improvement priority for home care, given that many home care clients experience falls. In this study, we identify factors associated with the rate of falls among home care clients.
We conducted a population-based, cross-sectional study using secondary data from the Hamilton, Niagara, Haldimand, and Brant health region of Ontario, Canada from January 1 - March 31, 2018. We captured person-level characteristics with falls from the Resident Assessment Instrument - Home Care (RAI-HC). Negative binomial regression was used to model the rate of falls.
Functional characteristics of home care clients had strong, statistically significant associations with the rate of falls. Declines in activities of daily living, assistive device use for locomotion indoors, polypharmacy, and health conditions, such as dizziness or lightheadedness, and parkinsonism, were associated with a higher rate of falls. Males who used assistive devices had a higher rate of falls compared to females; however, males with neurological and cardiovascular health conditions had a decrease in the rate of falls compared to females. Home care clients with parkinsonism who used a cane and took eight or more drugs had stronger associations with an increased rate of falls compared to those who do not have parkinsonism.
Functional characteristics, polypharmacy, and health conditions are associated with increased rates of falls among home care clients. Home care clients who are at a greater risk of falls may require environmental adjustments in their home to reduce or eliminate the possibility of falling.
老年人意外跌倒已成为导致与受伤相关的住院的主要原因。鉴于许多家庭护理客户经历过跌倒，减少跌倒一直是家庭护理的持续质量改进重点。在这项研究中，我们确定了与家庭护理客户跌倒率相关的因素。
我们使用加拿大安大略省汉密尔顿、尼亚加拉、哈尔迪曼德和布兰特健康区的 2018 年 1 月 1 日至 3 月 31 日的二次数据进行了基于人群的横断面研究。我们从居民评估工具-家庭护理（RAI-HC）中捕获了与跌倒相关的人员特征。我们使用负二项回归模型来模拟跌倒率。
家庭护理客户的功能特征与跌倒率有很强的统计学关联。日常生活活动能力下降、室内助行器使用、多药治疗以及头晕或头晕、帕金森病等健康状况与更高的跌倒率有关。与女性相比，使用助行器的男性跌倒率更高；然而，与女性相比，患有神经和心血管健康状况的男性跌倒率下降。使用手杖且服用八种或更多药物的患有帕金森病的家庭护理客户，与未患有帕金森病的家庭护理客户相比，跌倒率增加的关联更强。
功能特征、多药治疗和健康状况与家庭护理客户的跌倒率增加有关。跌倒风险较高的家庭护理客户可能需要对其家庭环境进行调整，以减少或消除跌倒的可能性。
