PRACTICE VARIATIONS IN PAIN CONTROL AT THE END OF LIFE

临终时疼痛控制的实践变化

• 批准号: 2796863
• 负责人: CHARLES S CLEELAND
• 金额: $ 7.54万
• 依托单位: UNIVERSITY OF TX MD ANDERSON CAN CTR
• 依托单位国家: 美国
• 财政年份: 1998
• 资助国家: 美国
• 起止时间: 1998-08-01 至 2000-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/2796863
• 关键词: age difference; analgesia; analgesics; behavioral /social science research tag; cancer pain; gender difference; health care professional practice; health care service evaluation; health insurance; health services research tag; human data; longitudinal human study; medical records; racial /ethnic difference; terminal patient care

This application seeks funding to pilot test a methodology for investigating patterns of analgesic pain treatment in patients with advanced cancer using health insurance claims data. Such a methodology would provide a relatively efficient way to learn more about the patterns of analgesic pain treatment in a large cross-section of the U.S. population, as well as to identify variations in the practice of pain management in population sub-groups. It would also allow us to estimate how consistently the guidelines for cancer pain management published by AHCPR in 1994 are being applied in different population groups. If successfully developed, this methodology could be used to perform further practice pattern studies in populations of interest, to evaluate the impact of pertinent regulatory changes on patient care before and after implementation, to evaluate the effect of well-treated vs. poorly-treated pain in terms of clinical outcomes, and to compare practice patterns of different health care payors, including publicly funded sources an health maintenance organizations. The proposed study will be a retrospective investigation of privately-funded insurance claims data. The specific aims of the project are: 1. To determine the feasibility of using insurance claims data for descriptive studies of analgesic pain treatment patterns. 2. To assess the concordance between insurance claims data and medical record documentation of pain treatment. 3. To determine whether there are differences in the level of pain treatment for those being treated in states with triplicate prescription programs (with tight control of opioid analgesics) compared to those in states where this is not the case. 4. To determine whether pain treatment practices differ for various population sub-groups such as members of specific minority of gender groups, and the elderly.

该申请寻求资金，以试点测试一种方法， 调查患者的镇痛治疗模式 使用健康保险索赔数据的晚期癌症。 这种方法 将提供一个相对有效的方式来了解更多关于 在一个大的横截面的镇痛疼痛治疗模式， 美国人口，以及确定在实践中的变化， 在人群亚组中进行疼痛管理。 这也将使我们能够 估计癌症疼痛管理指南的一致性 AHCPR在1994年发表的一份报告正在不同人群中应用 组 如果开发成功，这种方法可用于 在感兴趣的人群中进行进一步的实践模式研究， 评估相关法规变化对患者护理的影响 实施前后，以评估良好的治疗效果 vs.在临床结局方面治疗不良的疼痛，并比较 不同医疗保健支付者的实践模式，包括公开 资金来源是健康维护组织。 拟定研究 将对私人出资的保险进行回顾性调查 索赔数据。 该项目的具体目标是：1。确定 使用保险索赔数据进行描述性研究的可行性 止痛药治疗模式。2.为了评估 疼痛的保险索赔数据和医疗记录文件 治疗3.以确定是否存在水平差异 疼痛治疗的国家， 处方计划（严格控制阿片类镇痛药）比较 而在其他州，情况并非如此。4.以确定是否 疼痛治疗实践对于各种人群亚组不同， 作为特定少数性别群体的成员，以及老年人。