Burdens of multimorbidity on hospitalization and mortality in nursing home residents with obesity

项目摘要 养老院的居民，像所有年龄段的美国人一样，越来越多地患有肥胖症。肥胖发展 通常在存在其他慢性疾病的情况下，包括心血管疾病，糖尿病，关节炎， 和一些癌症。与体重正常的人相比，肥胖的居民在 活动，通常从椅子上站起来，行走和保持平衡都有困难。因此，护理 养老院的提供者越来越多地面临着同时管理多种慢性疾病的前景， 这些居民的条件和功能限制。使用国家最低限度数据集， 医疗保险提供者分析和审查（MedPAR）文件（2012-2015），本R 03项目旨在1）表征 养老院肥胖居民的多项指标星座。这将包括：（a）确定 最常见的1、2、3、4、5或5以上并发条件;以及B）区分以下星座的模式： 分别在I类、II类和III类肥胖的居民中，2)的影响进行评估 A1中发现的多死亡率，对养老院肥胖居民的死亡率的影响。3)的影响进行评估 A1中发现的多发性硬化症，在患有肥胖症的疗养院居民中住院。本研究将 提供养老院居民中流行状况星座的描述性信息， 肥胖，并确定这些人的亚组在可预防的住院和死亡的高风险。 研究结果将支持临床医生了解如何有针对性地采取干预措施来改善护理， 高危人群中的个体。这项研究涉及卫生和人类服务部2010年 关于多种慢性病的战略框架，该框架要求进行研究，“了解 ”（目标4，具体目标B），并加强目前关于“ 最普遍和最重要的.[和]告知有效的 干预措施。”

PROJECT SUMMARY Nursing home residents, like Americans of all ages, suffer increasingly from obesity. Obesity develops frequently in the presence of other chronic conditions, including cardiovascular diseases, diabetes, arthritis, and some cancers. Compared to those with normal weight, residents with obesity experience more pain with activity, and typically have more difficulty rising from a chair, walking, and maintaining balance. Thus, care providers in nursing homes increasingly face the prospect of simultaneously managing multiple chronic conditions and functional limitations among these residents. Using national Minimum Data Set (MDS) and Medicare Provider Analysis and Review (MedPAR) files (2012-2015), this R03 project aims to 1) characterize constellations of multimorbidity among nursing home residents with obesity. This will include: a) identifying the most common 1, 2, 3, 4, 5, or 5 above concurrent conditions; and b) distinguishing patterns of constellations of multimorbidity among residents with class I, class II and class III obesity, respectively. 2) assess the impact of multimorbidity, found in A1, on death among nursing home residents with obesity. 3) assess the impact of multimorbidity, found in A1, on hospitalization among nursing home residents with obesity. This study will provide descriptive information of constellations of prevalent conditions among nursing home residents with obesity, and identify subgroups of these individuals at high risk of preventable hospitalization and of mortality. The study results will support clinicians with insight about how interventions to improve care can be targeted to individuals in high-risk groups. This study addresses the Department of Health and Human Services' 2010 Strategic Framework on Multiple Chronic Conditions, which calls for studies to “understand the epidemiology of multiple chronic conditions” (Goal 4, Objective B) and augment the currently limited research about “the constellations of conditions that are most prevalent and most important …[and] to inform effective interventions.”