Outcomes, Incentives, and Improvements in Collaboratives

合作的成果、激励措施和改进

• 批准号: 6600864
• 负责人: MARSHALL H CHIN
• 金额: $ 46.16万
• 依托单位: UNIVERSITY OF CHICAGO
• 依托单位国家: 美国
• 财政年份: 2002
• 资助国家: 美国
• 起止时间: 2002-09-30 至 2005-09-29
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6600864
• 关键词: behavioral /social science research tag; cooperative study; cost effectiveness; diabetes mellitus; health care personnel performance; health care quality; health care service evaluation; health care service planning; health services research tag; human subject; interview; medical records; medically underserved population; outcomes research; patient care management; patient oriented research; satisfaction

DESCRIPTION (provided by applicant): In 1998 the Bureau of Primary Health Care (BPHC), the part of the Health Resources and Services Administration that oversees all federally-funded health centers, began a major 6-year Health Disparities Collaborative effort designed to reduce health disparities and improve the quality of care in health centers. The initiative aims for rapid quality improvement through the Institute for Healthcare Improvement's Breakthrough Series methodology, the MacColl Institute for Healthcare Innovation's Chronic Care Model, and regional or national learning sessions. Previous work by the University of Chicago indicated that care improved in the first year of the Collaborative, but that health centers had identified several challenges to further quality improvement. Therefore, the investigators have three specific aims: 1) To determine if the Health Disparities Collaboratives (HDC) have improved the quality of care and outcomes of patients over the six-year span of the initiative. 2) To determine ways to enhance the effectiveness, sustainability, and spread of the HDC, with a special emphasis on seeking to understand and improve incentives and assistance for both leaders and other staff at the health centers. 3) To evaluate the costs and cost-effectiveness of the HDC, in order to assess whether quality of care improvements that are effective, sustainable, and capable of spread are also viable financially from health center and societal perspectives. Investigators plan to study approximately 200 health centers in the Midwest and West Central regions of the country. On a subset of 32 health centers already involved in a Diabetes Collaborative evaluation, further chart review and patient surveys for performance indicators will be obtained. On the universe of 200 health centers, leaders and staff will be given written surveys with an emphasis on determining incentives and assistance that would be helpful, and semi-structured interviews will be performed on a subsample. Investigators will perform general cost descriptions, and use formal, well-validated models for diabetes cost-effectiveness analyses of the Collaborative. This project will help inform future efforts to improve chronic care management in health centers.

描述（由申请人提供）：1998年，初级卫生保健局（BPHC），卫生资源和服务管理局的一部分，负责监督所有联邦资助的卫生中心，开始了一项为期6年的重大健康差距合作计划，旨在减少健康差距，提高卫生中心的护理质量。该计划旨在通过医疗保健改善研究所的突破系列方法，MacColl医疗保健创新研究所的慢性护理模式以及区域或国家学习课程来快速提高质量。芝加哥大学以前的工作表明，护理在合作的第一年有所改善，但卫生中心已经确定了进一步提高质量的几个挑战。 因此，调查人员有三个具体目标： 1)确定健康差异合作组织（HDC）在该倡议的六年跨度内是否提高了护理质量和患者的结果。 2)确定如何提高HDC的有效性、可持续性和传播，特别强调寻求理解和改善对健康中心领导人和其他工作人员的激励和帮助。 3)评价HDC的成本和成本效益，以评估从卫生中心和社会角度来看，有效、可持续和能够传播的护理质量改善在经济上是否可行。 研究人员计划对该国中西部和中西部地区的大约200个健康中心进行研究。在已经参与糖尿病协作评估的32个健康中心的子集上，将获得进一步的图表审查和患者调查的性能指标。在200个卫生中心的范围内，将向领导和工作人员进行书面调查，重点是确定有帮助的激励措施和援助，并将对子样本进行半结构化访谈。研究人员将进行一般成本描述，并使用正式的，经过充分验证的模型进行糖尿病协作成本效益分析。该项目将有助于为未来改善健康中心慢性病护理管理的努力提供信息。