CORE--EXTERNAL INNOVATIVE INTERNATIONAL NETWORK

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The External Innovative International Network Core, builds from two Stanford-coordinated international research networks that have been active for the past four or more years. These networks address health policy issues facing wealthy, aging nations. In 1998, the Technological Changes in Healthcare (TECH) network was launched with NIA funding in order to conduct micro-data analysis of trends in technology diffusion and adoption for the care of acute myocardial infarction patients. In 1999, Stanford investigators initiated the Global Healthcare Productivity (GHP) collaboration with internal Stanford funding. Investigators formed GHP with the intention of studying the effects of variation in health care financing, regulation, and the organization of health care on practice patterns, outcomes, and costs for common diseases across countries. Both networks have completed several preliminary studies. The External Innovative International Network Core of CDEHA will provide an efficient infrastructure to our interpational collaborative activities. It will also support feasibility studies that could be developed into larger-scale projects. The initial substantive focus of the Core is on long-term care in wealthy nations, with a focus on the elderly with dementia, It has the following specific research aims: 1) Assembling a collection of longitudinal data sets with internationally-comparable long-term care (LTC) and disability variables, in addition to demographic, socioeconomic, and health utilization data elements; 2) conducting feasibility studies on available micro-data and their attributes to document valid methodologies that can be used in cross-national individual-level analyses in the areas of LTC and disability trends; 3) comparing patterns of LTC and utilization between the elderly with and without dementia, by studying variation in demography and in policies affecting. LTC supply, demand, and financing; and 4) describing similarities and disparities in disability trends throughout the human life-cycle and among nations. The Core research will be conducted in three phases: First, we will devote Years 1 and 2 to data collection and feasibility studies for both utilization of LTC for people with and without dementia and for disability trends; second, data analysis in both areas will follow in Years 3 and 4; and third, work product development and dissemination, while ongoing throughout the project, will be the focus of Year 5. The feasibility for development of national and international public-use files will be explored as part of this Core. We will determine the logistics and feasibility of making these data available to other interested researchers, while fully protecting data confidentiality and privacy, and complying with all applicable university, federal, and foreign regulations concerning data use.