The Use of Telemedicine in the Care of Nursing Home Residents with Alzheimer's Disease and Related Dementias During and After the COVID-19 Pandemic
在 COVID-19 大流行期间和之后使用远程医疗来护理患有阿尔茨海默病和相关痴呆症的疗养院居民
基本信息
- 批准号:10345587
- 负责人:
- 金额:$ 46.18万
- 依托单位:
- 依托单位国家:美国
- 项目类别:
- 财政年份:2022
- 资助国家:美国
- 起止时间:2022-04-01 至 2026-01-31
- 项目状态:未结题
- 来源:
- 关键词:Accident and Emergency departmentAddressAdministratorAdoptedAdoptionAlzheimer&aposs DiseaseAlzheimer&aposs disease careAlzheimer&aposs disease related dementiaAmericanAreaCOVID-19COVID-19 pandemicCaringCessation of lifeCharacteristicsClinicalDataData SetDementiaDiagnosisDropsElderlyEmergency department visitGeriatric PsychiatryGoalsHealthHealthcareHome Nursing CareHospitalizationHourIndividualKnowledgeLeadershipLiteratureLogisticsMeasuresMedicaidMedicalMedicareMedicare claimMissionModelingNeurologyNursing HomesOutcomePatient TransferPatientsPatternPerceptionPersonal SatisfactionPersonsPhysician ExecutivesPhysiciansPoliciesPopulationProviderPsychiatryReportingRuralSamplingServicesSkilled Nursing FacilitiesSurveysTelemedicineVaccinesVisitVulnerable Populationsbasecoronavirus diseasecostdisadvantaged populationhospitalization ratesimplementation barriersimplementation strategyimprovedimproved outcomeinnovationmedical specialtiesnovel coronaviruspandemic diseaseprograms
项目摘要
The Use of Telemedicine in the Care of Nursing Home Residents with Alzheimer's Disease and Related
Dementias During and After the COVID-19 Pandemic
PROJECT SUMMARY
The novel coronavirus disease 2019 (COVID-19) pandemic has devastated nursing home residents in
the US, nearly half of whom are diagnosed with Alzheimer's and other related dementias (ADRD). To limit
resident exposure and expand safe access to desperately-needed care from physicians and advanced practice
providers, Medicare dropped previously tight restrictions and temporarily allowed SNFs to broadly use
telemedicine to obtain care for residents. Dropping these restrictions helped facilitate a rapid adoption of
telemedicine in SNFs, from <1% of SNFs billing for any telemedicine services in Oct-Dec 2019 to 55% in Apr-
May 2020.
Telemedicine has long been regarded as a promising, but underused, delivery innovation for SNFs
addressing two major gaps in care. First, SNF clinicians are not always onsite, so medical issues that present
during off-hours are often addressed by transferring patients, often unnecessarily, to the emergency
department. Second, due to both financial and logistic reasons it is very difficult for SNF residents to obtain
specialty care, including specialties critical those with ADRD like neurology or psychiatry. A limited literature
suggests that telemedicine can bridge both of these care gaps, but more rigorous evidence is needed.
In 2021, understanding the adoption and clinical impact of SNF telemedicine for the vulnerable
population of older adults with ADRD has new urgency. We propose to use Medicare claims, the Minimum
Data Set and a national survey on SNF telemedicine implementation to answer the following specific aims:
1) Evaluate the patient-level association of SNF adoption of telemedicine in 2020 with health care use and
clinical outcomes (COVID-19 and non-COVID-19) for SNF residents with and without ADRD.
2) Use group-based trajectory models to characterize 2020-2021 SNF-level patterns of telemedicine use (e.g.,
sustaining vs. de-adopting) and SNF characteristics associated with different trajectories.
3) Survey a national sample of SNFs, stratified by their trajectories measured in Aim 2, to assess facility
leadership perceptions of telemedicine use and telemedicine implementation strategies.
Understanding how SNFs have used telemedicine and its association with clinical outcomes is
essential to inform how Medicare and state Medicaid programs should regulate and promote telemedicine use
in SNFs. Our findings will also help guide clinicians who care for SNF residents with ADRD on the clinical
impact associated with telemedicine use and how it is being used nationally.
远程医疗在老年性痴呆及相关疾病护理中的应用
2019冠状病毒病大流行期间和之后的痴呆症
项目摘要
2019年新型冠状病毒病(COVID-19)大流行摧毁了美国的养老院居民,
在美国,近一半的人被诊断患有阿尔茨海默氏症和其他相关痴呆症(ADRD)。限制
居民暴露,并扩大安全获得医生和先进实践的迫切需要的护理
提供者,医疗保险放弃了以前严格的限制,并暂时允许SNF广泛使用
远程医疗为居民提供医疗服务。取消这些限制有助于迅速采用
SNF中的远程医疗,从2019年10月至12月的任何远程医疗服务的SNF计费的<1%到2019年4月的55%。
2020年5月。
长期以来,远程医疗一直被认为是SNF的一项有前途但未充分利用的交付创新
解决护理方面的两大差距。首先,SNF临床医生并不总是在现场,因此存在的医疗问题
在非工作时间,通常通过将病人转移到急诊室来解决,
部门其次,由于财政和后勤方面的原因,SNF居民很难获得
专科护理,包括对ADRD患者至关重要的专科,如神经病学或精神病学。有限的文献
表明远程医疗可以弥合这两个护理差距,但需要更严格的证据。
2021年,了解SNF远程医疗对弱势群体的采用和临床影响
老年ADRD患者面临新的紧迫性。我们建议使用医疗保险索赔,最低
数据集和关于SNF远程医疗实施情况的全国调查,以实现以下具体目标:
1)评估2020年SNF采用远程医疗与医疗保健使用的患者水平相关性,
SNF居民(有和没有ADRD)的临床结局(COVID-19和非COVID-19)。
2)使用基于群体的轨迹模型来描述2020-2021年SNF级远程医疗使用模式(例如,
维持与不采用)和与不同轨迹相关联的SNF特性。
3)调查全国SNF样本,按目标2中测量的轨迹分层,以评估设施
领导层对远程医疗使用的看法和远程医疗实施战略。
了解SNF如何使用远程医疗及其与临床结果的关联,
必须告知医疗保险和州医疗补助计划应如何规范和促进远程医疗的使用
在SNF。我们的研究结果也将有助于指导临床医生谁照顾SNF居民与ADRD的临床
与远程医疗使用有关的影响以及如何在国内使用远程医疗。
项目成果
期刊论文数量(0)
专著数量(0)
科研奖励数量(0)
会议论文数量(0)
专利数量(0)
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Michael Lawrence Barnett其他文献
Spread of Pathogens in the Patient Transfer Network of US Hospitals
美国医院患者转运网络中病原体传播
- DOI:
- 发表时间:
2015 - 期刊:
- 影响因子:0
- 作者:
J. Fernández;J. Onnela;Michael Lawrence Barnett;V. Eguíluz;N. Christakis - 通讯作者:
N. Christakis
Business as usual? An exploration of the determinants of success in the multinational transfer of corporate responsibility initiatives
照常营业?
- DOI:
10.1515/bap-2012-0019 - 发表时间:
2012 - 期刊:
- 影响因子:1.8
- 作者:
Michael Lawrence Barnett;Sunyoung Lee - 通讯作者:
Sunyoung Lee
Taking Stock of Care Delivery Transformation.
评估护理服务转型。
- DOI:
- 发表时间:
2023 - 期刊:
- 影响因子:0
- 作者:
S. Gondi;Michael Lawrence Barnett - 通讯作者:
Michael Lawrence Barnett
Care delivery approaches and perceived barriers to improving quality of care: A national survey of skilled nursing facilities
护理提供方法和提高护理质量的障碍:对熟练护理设施的全国调查
- DOI:
- 发表时间:
2023 - 期刊:
- 影响因子:6.3
- 作者:
Amanda C Chen;A. Epstein;Karen E. Joynt Maddox;D. Grabowski;E. Orav;Michael Lawrence Barnett - 通讯作者:
Michael Lawrence Barnett
The "medical neighborhood": integrating primary and specialty care for ambulatory patients.
“医疗社区”:整合门诊患者的初级和专科护理。
- DOI:
10.1001/jamainternmed.2013.14093 - 发表时间:
2014 - 期刊:
- 影响因子:39
- 作者:
J. Greenberg;Michael Lawrence Barnett;M. Spinks;J. Dudley;J. Frolkis - 通讯作者:
J. Frolkis
Michael Lawrence Barnett的其他文献
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{{ truncateString('Michael Lawrence Barnett', 18)}}的其他基金
The Use of Telemedicine in the Care of Nursing Home Residents with Alzheimer's Disease and Related Dementias During and After the COVID-19 Pandemic
在 COVID-19 大流行期间和之后使用远程医疗来护理患有阿尔茨海默病和相关痴呆症的疗养院居民
- 批准号:
10594541 - 财政年份:2022
- 资助金额:
$ 46.18万 - 项目类别:
Physician Subspecialization and the Health and Health Care of Older Americans
医生亚专业化与美国老年人的健康和保健
- 批准号:
10708114 - 财政年份:2022
- 资助金额:
$ 46.18万 - 项目类别:
Physician Subspecialization and the Health and Health Care of Older Americans
医生亚专业化与美国老年人的健康和保健
- 批准号:
10584875 - 财政年份:2022
- 资助金额:
$ 46.18万 - 项目类别:
The Changing Landscape of Post-Acute Care and Health Outcomes for Older Adults
老年人急性后护理和健康结果的变化
- 批准号:
10370357 - 财政年份:2018
- 资助金额:
$ 46.18万 - 项目类别:
The Changing Landscape of Post-Acute Care and Health Outcomes for Older Adults
老年人急性后护理和健康结果的变化
- 批准号:
9895614 - 财政年份:2018
- 资助金额:
$ 46.18万 - 项目类别:
Improving Specialty Care Delivery in the Safety Net with Natural Language Processing
通过自然语言处理改善安全网中的专业护理服务
- 批准号:
9789060 - 财政年份:2018
- 资助金额:
$ 46.18万 - 项目类别:
The Changing Landscape of Post-Acute Care and Health Outcomes for Older Adults
老年人急性后护理和健康结果的变化
- 批准号:
10253539 - 财政年份:2018
- 资助金额:
$ 46.18万 - 项目类别:
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