SUBOPTIMAL DRUG USE AND HEALTH OUTCOMES

这项研究的目的是确定不适当的 社区住宅健康相关结果处方 老人 不适当的处方由两个不同的标准定义： 1)不适当的药物使用，如Beers et.（1991）; 2） 根据合同制定的不适当药物使用标准， HCFA对《医疗保险灾难性覆盖法案》的回应 1988. 测量的结果包括功能状态（通过 日常生活的基本和工具性活动以及行动能力）、健康 服务利用（住院、机构化、急诊 房间和医生办公室访问）和相关的成本，以及死亡率。 调查人员计划研究是否与 不适当的处方和结果受到以下因素的影响， 年龄、性别、种族、城市/农村居住地和合并症。 一 将使用基于人群的纵向设计。 具体 要检验的假设是，与不接受教育的老年人相比， 不适当的处方，不适当的老年参与者 处方将有更大的功能下降，增加利用 卫生服务，费用增加， 控制重要的协变量（例如合并症）。 研究 将分析来自国家研究所的现有数据集， 老龄化（NIA）资助的杜克大学流行病学既定人群 老年人研究（EPES）。

The study's objective is to determine the impact of inappropriate prescribing on health-related outcomes for community dwelling elderly. Inappropriate prescribing is defined by two different criteria: 1) inappropriate medication use as defined by Beers et. al. (1991); 2) inappropriate medication use criteria developed under contract to HCFA in response to the Medicare Catastrophic Coverage Act of 1988. Outcomes measured include functional status (as measured by basic and instrumental activities of daily living, and mobility), health services utilization (hospitalization, institutionalization, emergency room and physician office visits) and associated costs, and mortality. Investigators plan to examine whether the relationship between inappropriate prescribing and outcomes are affected by factors such as age, gender, race, urban/rural residence and comorbidities. A longitudinal design that is population based will be used. The specific hypotheses to be tested are that, compared with elders not receiving inappropriate prescriptions, elderly participants with inappropriate prescribing will have greater functional decline, increased utilization of health services, higher costs and increased likelihood of death after controlling for important covarites (e.g. comorbidities). The study will analyze a pre-existing data set from the National Institute on Aging (NIA)-funded Duke Established Populations for Epidemiologic Studies of the Elderly (EPESE).