Data on Femoral Fracture Reported by Researchers at University Medical Center (Long-Term Effectiveness of a Multifactorial Fall and Fracture…

Data on Femoral Fracture Reported by Researchers at University Medical Center (Long-Term Effectiveness of a Multifactorial Fall and Fracture Prevention Program in Bavarian Nursing Homes: An Analysis Based on Health Insurance Claims Data)

By a News Reporter-Staff News Editor at Managed Care Weekly Digest -- A new study on Femoral Fracture is now available. According to news reporting originating in Hamburg, Germany, by NewsRx journalists, research stated, "Femoral fractures are frequently consequences of falls in nursing homes and are associated with considerable costs and unfavorable outcomes such as immobility and mortality. The purpose of this study was to examine the long-term effectiveness of a multifactorial fall and fracture prevention program in nursing homes in terms of reducing femoral fractures."

The news reporters obtained a quote from the research from University Medical Center, "Retrospective cohort study. Nursing homes. Health insurance claims data for 2005-2013 including 85,148 insurants of a sickness fund (Allgemeine Ortskrankenkasse Bayern), aged 65 years or older and living in 802 nursing homes in Bavaria, Germany. The fall prevention program was implemented stepwise in 4 time-lagged waves in almost 1,000 nursing homes in Bavaria, Germany, and was financially supported by a Bavarian statutory health insurance for the initial period of 3 years after implementation. The components of Bavarian Fall and Fracture Prevention Program were related to the staff (education), to the residents (progressive strength and balance training, medication, hip protectors), and suggested environmental adaptations as well as fall documentation and feedback on fall statistics. Data were used to create an unbalanced panel data set with observations per resident and quarterly period. We designed each wave to have 9 quarters (2.25 years) before implementation and 15 quarters (3.75 years) as follow-up period, respectively. Time trend adjusted logistic generalized estimating equations were used to examine the impact of implementation of the fall prevention program on the likelihood of femoral fractures, controlling for resident and nursing home characteristics. The analysis took into account that the fall prevention program was implemented in 4 time-lagged waves. The implementation of the fall prevention program was not associated with a significant reduction in femoral fractures. Only a transient reduction of femoral fractures in the first wave was observed. Patient characteristics were positively associated with the likelihood of femoral fractures (P < .001); women compared to men [odds ratio (OR) = 0.877], age category 2 (OR = 1.486) and 3 (OR = 1.973) compared to category 1, care level 1 compared to 2 (OR = 0.897) and 3 (OR = 0.426), and a prior fracture (OR = 2.230) significantly increased the likelihood of a femoral fracture. There was no evidence for the long-term effectiveness of the fall prevention program in nursing homes. The restriction of the transient reduction to the first implementation wave may be explainable by a higher motivation of nursing homes starting first with the fall prevention program."

According to the news reporters, the research concluded: "Efforts should be directed to further identify factors that determine the long-term effectiveness of fall prevention programs in nursing homes."

For more information on this research see: Long-Term Effectiveness of a Multifactorial Fall and Fracture Prevention Program in Bavarian Nursing Homes: An Analysis Based on Health Insurance Claims Data. Journal of the American Medical Directors Association, 2017;18(6):190-200. Journal of the American Medical Directors Association can be contacted at: Elsevier Science Inc, 360 Park Ave South, New York, NY 10010-1710, USA. (Elsevier - www.elsevier.com; Journal of the American Medical Directors Association - www.journals.elsevier.com/journal-of-the-american-medical-directors-association/)

Our news correspondents report that additional information may be obtained by contacting C. Schulz, Eppendorf University Medical Center, Dept. of Hlth Econ & Hlth Serv Res, D-20246 Hamburg, Germany. Additional authors for this research include I. Lindlbauer, K. Rapp, C. Becker and H.H. Konig (see also Femoral Fracture).

Keywords for this news article include: Hamburg, Germany, Europe, Femoral Fractures, Health Insurance, University Medical Center.

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