Delivering Effective Primary Care to Older Adults

简介(由申请人提供)：Phelan博士的长期目标是成为改善老年人健康服务质量的领导者，特别是初级保健。到目前为止，她的研究结合了她在健康促进、卫生保健质量和弱势群体方面的兴趣，并涉及调查方法和对现有数据的分析。在K23获奖期间，她将遵循一项研究和培训计划，以确保她将拥有作为独立调查员进行以患者为中心的研究的技能和经验。她的研究和培训将由爱德华·H·瓦格纳博士监督。老年医学专业知识和学术职业指导将由ITamar B.Abrass博士提供。合作者/顾问将包括Andrea Z.LaCroix博士和Eric B.Larson；James P.Logerfo将担任顾问。 在老年人的护理中，保持功能和独立性是一个重要的健康结果。对功能衰退的个体(患者)风险因素进行了深入研究，并对特定风险因素进行了重点干预。然而，对提供者实践或实践设计特征对老年人功能状态的影响知之甚少。拟议的研究将解决这些问题。具体目标是：1)评估服务提供者执业风格对患者功能状态的影响；2)评估将老年护理团队整合到门诊和初级护理中的可行性和有效性。拟议的项目将由候选人领导，并由她的赞助人瓦格纳博士监督。这些调查应有助于为改善老年人的初级保健提供新的见解，以促进继续独立运作。 通过允许Phelan博士1)获得高级流行病学和统计技术方面的正式培训，以及2)在初级保健环境下的新护理模式的随机试验中发挥主导作用，指导患者定向研究职业发展奖将使她能够实现她5年来实现独立研究员地位的目标，并推动她朝着上述长期职业目标前进。

DESCRIPTION (provided by applicant): Dr Phelan aims in the long-term to become a leader in improving the quality of health services, particularly primary care, for the elderly. Her research to date has combined her interests in health promotion, health care quality, and vulnerable populations and has involved survey methods and analyses of existing data. During the period of this K23 award, she will follow a program of research and training to ensure that she will possess both the skills and the experience to conduct patient orionred research as an independent investigator. Her research and training will be overseen by Dr Edward H. Wagner. Geriatric expertise and academic career guidance will be provided by Dr Itamar B. Abrass. Collaborators/advisors will include Drs Andrea Z. LaCroix and Eric B. Larson; James P. LoGerfo will serve as an advisor. Preserving function and independence is an important health outcome in the care of older adults. Individual (patient) risk factors for functional decline have been intensely studied, as have focused interventions for specific risk factors. However, little is known about the effects of provider practice or practice design features on the functional status of older adults. The proposed research will address these questions. The specific aims are: 1) to evaluate the effect of provider practice style on patient functional status and 2) to evaluate the feasibility and efficacy of integrating a geriatric care team into outpatient, primary care. The proposed projects will be led by the candidate under the supervision of her Sponsor, Dr Wagner. These investigations should contribute new insights into improving primary care of older adults in order to promote continued independent functioning. By permitting Dr Phelan to 1) obtain formal training in advanced epidemiologic and statistical techniques and 2) take a lead role in the conduct of a randomizod trial of a new model of care for primary care settings, the Mentored Patient Orionted Research Career Development Award will enable her to meet her 5-year goal of achieving independent investigator status and move her toward her Iong-term, career goal described above.