Challenges and Opportunities in Advancing Models of Care for Older Adults: An Assessment of the National Institute on Aging Research Portfolio
Challenges and Opportunities in Advancing Models of Care for Older Adults: An Assessment of the National Institute on Aging Research Portfolio
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DOI：
10.1111/j.1532-5415.2010.03157.x
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发表时间：
2010-12-01
影响因子：
6.3
通讯作者：
Bernard, Marie A.
中科院分区：
文献类型：
--
作者：
Liggins, Charlene;Pryor, Lisa;Bernard, Marie A.
识别由国家老龄化研究所（NIA）支持的现有项目，这些项目可能与2008年医学研究所报告中提出的护理模式（MOC）建议有关，为美国老龄化重新装备：建立医疗保健劳动力。NIA赠款组合的截面分析。SETTINGNIA。PARTICIPANTSNIA赠款接受者。MEASUREMENTSNIA赠款组合在1999年至2008年期间被查询使用与MOC相关的各种搜索词。入选标准是遵守MOC的指导原则（全面护理，有效护理，老年人作为积极的合作伙伴）或关注MOC的创新特征（跨学科护理，护理管理，慢性病自我管理，药物管理，预防性家访，积极康复，过渡性护理）。排除标准是缺乏对干预措施的关注和对非正式照顾者的关注。国家执行机构的专家工作人员审查并确认了项目。这些赠款占不到1%的赠款金NIA在同一时期资助的近似数量（类似于24，000笔赠款）。44%的人关注综合护理的组成部分，34%的人关注老年人的积极参与。大约一半的人专门关注MOC的创新功能，从慢性病自我管理（32%）和主动康复（26%）到预防性家访（1%）和过渡性护理（1%）。大多数项目是赞助者发起的赠款（46%）。结论：NIA支持了许多干预措施的制定，其中包括与IOM报告中的建议相关的MOC组成部分。未来的挑战将是确定综合护理系统的许多组成部分中的哪些对老年人口的哪些子集最有效，并评估公共和私人老龄化研究利益相关者之间加强合作的机会。
OBJECTIVESTo identify existing projects supported by the National Institute on Aging (NIA) that may relate to the recommendations for models of care (MOCs) presented in the 2008 Institute of Medicine Report, Retooling for an Aging America: Building the Healthcare Workforce.DESIGNCross-sectional analysis of NIA's grant portfolio.SETTINGNIA.PARTICIPANTSNIA grantees.MEASUREMENTSNIA's grant portfolio was queried for the period 1999 to 2008 using a variety of search terms related to MOCs. Inclusion criteria were adherence to guiding principles for MOCs (comprehensive care, efficient care, older person as an active partner) or focus on innovative feature(s) of MOCs (interdisciplinary care, care management, chronic disease self-management, pharmaceutical management, preventive home visits, proactive rehabilitation, transitional care). Exclusion criteria were lack of focus on an intervention and focus on informal caregivers. Expert NIA staff reviewed and validated projects.RESULTSOne hundred thirty-five grants were identified. These grants represent fewer than 1% of the approximate number of grants NIA has funded over this same period of time (similar to 24,000 grants). Forty-four percent focused on components of comprehensive care and 34% on active involvement of older adults. Approximately half specifically focused on innovative features of MOCs, ranging from chronic disease self-management (32%) and proactive rehabilitation (26%) to preventive home visits (1%) and transitional care (1%). The majority of projects were investigator-initiated grants (46%).CONCLUSIONNIA has supported the development of many interventions that include components of MOCs related to recommendations from the IOM report. The challenge for the future will be determining which of the many components of comprehensive care systems are most effective for which subsets of the elderly population and assessing opportunities for enhanced collaboration between public and private aging research stakeholders.