Evaluating Policy Solutions Aimed at Improving Hospice Care Access in Rural Areas
评估旨在改善农村地区临终关怀服务的政策解决方案
基本信息
- 批准号:10555012
- 负责人:
- 金额:$ 20.51万
- 依托单位:
- 依托单位国家:美国
- 项目类别:
- 财政年份:2023
- 资助国家:美国
- 起止时间:2023-04-01 至 2028-01-31
- 项目状态:未结题
- 来源:
- 关键词:AddressAreaCaregiversCaringCharacteristicsCommunicationComplexEligibility DeterminationEnrollmentGrantHealth Services AccessibilityHospice CareIndividualInterventionInterviewKnowledgeMarkov chain Monte Carlo methodologyMedicareMethodsModelingPatient PreferencesPatientsPatternPerceptionPoliciesPolicy MakerPopulation DensityPovertyPredictive FactorProviderResearchResidual stateRuralRural Health CentersScienceServicesStructureTestingTimeTravelUnited States Centers for Medicare and Medicaid ServicesVoluntary ProgramsWorkacute carebeneficiarycommunity partnershipcultural valuesend of lifeend of life carehealth beliefhealth care deliveryhospice environmentimprovedinnovationlarge datasetsmodels and simulationnovelprogramsrural arearural patientssuccessurban area
项目摘要
PROJECT SUMMARY/ABSTRACT
Project 4 (Gilstrap): Evaluating Policy Solutions Aimed at Improving Hospice Care Access in Rural Areas
In 2016, almost 1.5 million Medicare beneficiaries enrolled in hospice and an equal number, if not more, were
eligible but chose not to enroll. Hospice can provide a myriad of benefits for patients and caregivers, and has
been shown to decrease futile care at the end of life, making under-enrollment a problem. With only 34% of
rural decedents enrolled in hospice as compared to the 51% in urban areas, rural under-enrollment contributes
to a higher rate of acute care at end of life. In 2016, the Center for Medicare and Medicaid Services (CMS)
launched the Medicare Care Choices Model (MCCM). This voluntary program aimed to address the
“acceptability,” aspect of hospice access, by allowing patients to enroll in hospice without stopping treatment
for their terminal condition. Though early results suggest that the program increased enrollment and decreased
spending, it remains unclear how the MCCM program performed in rural areas, what factors predicted
success in rural areas, and whether increased demand for services was met by rural hospice agencies.
This project will investigate these gaps in knowledge using relevant, timely, and innovative analyses and
methods. As the research team works to examine the impact of MCCM in rural areas, determine the residual
barriers to hospice expansion in rural areas, and model the estimated impacts of various policy solutions, they
will leverage large data sets, novel crosswalks, qualitative interviews, and simulation modeling. The work on
this project will ultimately prepare the PI, Dr. Gilstrap, to develop and submit an R01 application with the aim of
implementing and testing strategies identified in this grant to quantify their impact on rural hospice enrollment.
项目总结/摘要
项目4(Gilstrap):评估旨在改善农村地区临终关怀服务的政策解决方案
2016年,近150万医疗保险受益人参加了临终关怀,如果不是更多的话,
符合条件,但选择不参加。临终关怀可以为病人和护理人员提供无数的好处,
已被证明可以减少生命结束时的无效护理,使注册不足成为一个问题。只有34%的
农村死亡者参加临终关怀,而城市地区为51%,农村入学率不足
到生命末期的更高的急症护理率。2016年,医疗保险和医疗补助服务中心(CMS)
医疗保险选择模式(MCCM)这项自愿方案旨在解决
“可接受性”,临终关怀准入的一个方面,允许患者在不停止治疗的情况下参加临终关怀
因为他们的临终状态尽管早期的结果表明,该计划增加了入学人数,
目前还不清楚MCCM计划在农村地区的表现如何,预测的因素是什么,
农村地区的成功以及农村临终关怀机构是否满足了对服务的需求。
本项目将利用相关、及时和创新的分析,
方法.随着研究小组努力研究MCCM在农村地区的影响,
农村地区临终关怀扩展的障碍,并模拟各种政策解决方案的估计影响,
将利用大型数据集,新颖的人行横道,定性访谈和模拟建模。的工作
该项目最终将为PI Gilstrap博士做好准备,以开发和提交R 01申请,目的是
实施和测试该补助金中确定的策略,以量化其对农村临终关怀入学率的影响。
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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Lauren Gray Gilstrap其他文献
30-DAY, POST-HOSPITALIZATION OUTCOMES AMONG MEDICARE BENEFICIARIES WITH HFREF, 2008-2016
- DOI:
10.1016/s0735-1097(22)01248-7 - 发表时间:
2022-03-08 - 期刊:
- 影响因子:
- 作者:
Lauren Gray Gilstrap;Christopher Leggett;James O’Malley;Amber Barnato;Anna N.A. Tosteson;Jonathan Skinner - 通讯作者:
Jonathan Skinner
ONE-YEAR, P2Y12 ADHERENCE AFTER DRUG ELUTING STENT PLACEMENT AMONG MEDICARE BENEFICIARIES AND THE IMPACT OF “FIRST P2Y12” CHOICE
- DOI:
10.1016/s0735-1097(19)30703-x - 发表时间:
2019-03-12 - 期刊:
- 影响因子:
- 作者:
Lauren Gray Gilstrap;Micah Aaron;Robert Wild;Nancy Beaulieu;Michael Chernew;Mary Beth Landrum - 通讯作者:
Mary Beth Landrum
VARIATION BY AGE IN THE USE OF NEUROHORMONAL THERAPY IN ISCHEMIC HEART FAILURE WITH REDUCED EJECTION FRACTION
- DOI:
10.1016/s0735-1097(19)31308-7 - 发表时间:
2019-03-12 - 期刊:
- 影响因子:
- 作者:
Lauren Gray Gilstrap;Micah Aaron;Rob Wild;Nancy Beaulieu;Michael Chernew;Mary Beth Landrum - 通讯作者:
Mary Beth Landrum
GDTM USE AMONG MEDICARE BENEFICIARIES WITH HFREF, 2008-2015
- DOI:
10.1016/s0735-1097(22)01335-3 - 发表时间:
2022-03-08 - 期刊:
- 影响因子:
- 作者:
Lauren Gray Gilstrap;Christopher Leggett;James O’Malley;Amber Barnato;Anna N.A. Tosteson;Jonathan Skinner - 通讯作者:
Jonathan Skinner
RECURRENT MYOPERICARDITIS DUE TO AUTOIMMUNE POLYGLANDULAR SYNDROME 2
- DOI:
10.1016/s0735-1097(23)03944-x - 发表时间:
2023-03-07 - 期刊:
- 影响因子:
- 作者:
Christopher Lee;Sam Dow;Stanislav Henkin;Lauren Gray Gilstrap;Cynthia C. Taub - 通讯作者:
Cynthia C. Taub
Lauren Gray Gilstrap的其他文献
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{{ truncateString('Lauren Gray Gilstrap', 18)}}的其他基金
The Impact of Quality Metrics on Outcomes Among Elderly Heart Failure Patients
质量指标对老年心力衰竭患者预后的影响
- 批准号:
10207751 - 财政年份:2018
- 资助金额:
$ 20.51万 - 项目类别:
The Impact of Quality Metrics on Outcomes Among Elderly Heart Failure Patients
质量指标对老年心力衰竭患者预后的影响
- 批准号:
10181108 - 财政年份:2018
- 资助金额:
$ 20.51万 - 项目类别:
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