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

Abstract

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

• Hip fracture
• Community interventions
• Natural experiments
• Difference-in-differences
• Matching