Causes and Consequences of Health Care Intensity

医疗保健强度的原因和后果

• 批准号: 6637832
• 负责人: JONATHAN S SKINNER
• 金额: $ 125.98万
• 依托单位: DARTMOUTH COLLEGE
• 依托单位国家: 美国
• 财政年份: 2001
• 资助国家: 美国
• 起止时间: 2001-09-15 至 2006-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6637832
• 关键词: extended care; health care service availability; health care service utilization

DESCRIPTION (provided by applicant): In 1996, average Medicare per capita expenditures were $3,700 in Minneapolis and $7,783 in Miami. Differences of a similar magnitude were observed across regions in patterns of end-of-life care, such as the chances of dying in a hospital or the number of different specialists seen in the last 6 months of life. Previous research indicates that these geographic variations in treatment are due largely to differences in intensity, i.e., differences in the way similar patients are treated. Improved understanding of the causes and consequences of regional variations in intensity could have important implications for the health and well-being of the elderly, for addressing health disparities and for the financial health of the Medicare trust funds. This project addresses these issues by: 1. Measuring how patients of similar illness levels are treated differently across regions with respect to both overall intensity and different dimensions of intensity. 2. Determining the causes of differences in intensity. To what extent are they due to patient preferences for care, physician beliefs, or other factors? Why is it the norm in some regions but not others for elderly patients to experience extensive diagnostic testing for CAD, with subsequent downstream procedures, specialist referrals, and hospitalization? 3. Studying the consequences of greater health care intensity. What is the impact of greater intensity of care on outcomes that include survival, health functioning, and well-being more generally? 4. Seeking to understand how health care intensity, either across regions or over time, affects disparities across socioeconomic groups in health care treatments and outcomes. The project will bring together a cross-disciplinary research team comprised of investigators from the DAWG; the PORT; the Maine Medical Center; the Center for Survey Research in Boston, MA; Massachusetts General Hospital; and the National Bureau of Economic Research.

描述（由申请人提供）：1996年，人均医疗保险 明尼阿波利斯的支出为3,700美元，迈阿密为7,783美元。a的差异 在各区域的寿命终了模式中， 护理，如在医院死亡的机会或不同的数量， 在生命的最后6个月看到的专家。先前的研究表明， 这些治疗的地理差异主要是由于 在强度上，即，相似患者的治疗方式不同。 更好地了解区域差异的原因和后果 强度可能会对健康和福祉产生重要影响， 解决健康差距和财务健康问题 医疗保险信托基金。该项目通过以下方式解决这些问题： 1.衡量类似疾病水平的患者如何得到不同的治疗 就总体强度和不同层面而言， 强度。 2.确定强度差异的原因。在多大程度上 它们是由于病人对护理的偏好、医生的信念或其他因素造成的？ 为什么老年患者在某些地区是正常的，而在其他地区则不是。 经历了广泛的CAD诊断测试， 程序、专家转诊和住院治疗？ 3.研究更大的医疗保健强度的后果。是什么 更高强度的护理对结果的影响，包括生存、健康 更广泛地讲，幸福？ 4.寻求了解医疗保健强度如何，无论是跨地区还是 随着时间的推移，影响到社会经济群体在医疗保健方面的差异， 治疗和结果。 该项目将汇集一个跨学科的研究团队， 来自DAWG、PORT、缅因州医疗中心、中心的研究人员 马萨诸塞州波士顿的调查研究;马萨诸塞州总医院;以及 国家经济研究局。