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

肥胖疗养院居民的住院和死亡率的多重发病负担

• 批准号: 10226358
• 负责人: Ning Zhang
• 金额: $ 8.47万
• 依托单位: UNIVERSITY OF MASSACHUSETTS AMHERST
• 依托单位国家: 美国
• 财政年份: 2020
• 资助国家: 美国
• 起止时间: 2020-08-01 至 2024-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10226358
• 关键词: Address; Adopted; Age; American; Arthritis; Body mass index; Cardiovascular Diseases; Caring; Cessation of life; Characteristics; Chronic; Clinical Practice Guideline; Data Set; Diabetes Mellitus; Diagnosis; Elderly; Epidemiology; Equilibrium; Exhibits; Face; Foundations; Goals; High Prevalence; Home Nursing Care; Hospitalization; Individual; Intervention; Malignant Neoplasms; Measures; Medical; Medicare; Morbid Obesity; Nursing Homes; Obesity; Outcome; Pain; Pattern; Prevalence; Process; Provider; Research; Risk; Subgroup; United States Dept. of Health and Human Services; Walking; Weight; Work; beneficiary; care outcomes; care providers; effective intervention; experience; high body mass index; high risk; high risk population; improved; insight; mortality; mortality risk; multiple chronic conditions; nursing care quality; obesity management

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.”

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 疗养院的提供者越来越多地面临同时管理多种慢性病的前景 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： 分别为I级、II级和III级肥胖居民的多发病率。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，并确定这些人中处于可预防住院和死亡高风险的亚组。 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”。