Background falls are common in older people, but evidence for the effectiveness of preventative home adaptations is limited. Aim determine whether a national home adaptation service, Care&Repair Cymru (C&RC), identified individuals at risk of falls occurring at home and reduced the likelihood of falls. Study Design retrospective longitudinal controlled non-randomised intervention cohort study. Setting our cohort consisted of 657,536 individuals aged 60+ living in Wales (UK) between 1 January 2010 and 31 December 2017. About 123,729 individuals received a home adaptation service. Methods we created a dataset with up to 41 quarterly observations per person. For each quarter, we observed if a fall occurred at home that resulted in either an emergency department or an emergency hospital admission. We analysed the data using multilevel logistic regression. Results compared to the control group, C&RC clients had higher odds of falling, with an odds ratio (OR [95% confidence interval]) of 1.93 [1.87, 2.00]. Falls odds was higher for females (1.44 [1.42, 1.46]), older age (1.07 [1.07, 1.07]), increased frailty (mild 1.57 [1.55, 1.60], moderate 2.31 [2.26, 2.35], severe 3.05 [2.96, 3.13]), and deprivation (most deprived compared to least: 1.16 [1.13, 1.19]). Client fall odds decreased post-intervention; OR 0.97 [0.96, 0.97] per quarter. Regional variation existed for falls (5.8%), with most variation at the individual level (31.3%). Conclusions C&RC identified people more likely to have an emergency fall admission occurring at home, and their service reduced the odds of falling post-intervention. Service provisioning should meet the needs of an individual and need varies by personal and regional circumstance.

中文翻译：

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家庭适应干预措施是否有助于减少紧急秋季入院？对 2010 年至 2017 年间居住在威尔士（英国）的 657,536 名老年人进行的全国纵向数据关联研究

背景跌倒在老年人中很常见，但预防性家庭适应的有效性的证据有限。目的是确定国家家庭适应服务机构 Care&Repair Cymru (C&RC) 是否识别出在家中发生跌倒风险的个人并降低跌倒的可能性。研究设计回顾性纵向对照非随机干预队列研究。我们的队列由 2010 年 1 月 1 日至 2017 年 12 月 31 日期间居住在威尔士（英国）的 657,536 名 60 岁以上的人组成。大约 123,729 人接受了家庭适应服务。方法 我们创建了一个数据集，每人最多可进行 41 个季度观察。对于每个季度，我们观察家中是否发生跌倒导致急诊室或急诊入院。我们使用多级逻辑回归分析数据。结果与对照组相比，C&RC 客户跌倒的几率更高，优势比（OR [95% 置信区间]）为 1.93 [1.87, 2.00]。女性 (1.44 [1.42, 1.46])、年龄较大 (1.07 [1.07, 1.07])、虚弱程度增加 (轻度 1.57 [1.55, 1.60]、中度 2.31 [2.26, 2.35]、重度 3.05 [2.96]、 3.13]）和剥夺（与最少相比：1.16 [1.13, 1.19]）。干预后客户跌倒的几率降低；或每季度 0.97 [0.96, 0.97]。跌倒存在地区差异（5.8%），大部分差异在个体层面（31.3%）。结论 C&RC 确定了更有可能在家中发生紧急跌倒入院的人，他们的服务降低了干预后跌倒的几率。