Causes and Consequences of Health Care Intensity

医疗保健强度的原因和后果

• 批准号: 6936452
• 负责人: JONATHAN S SKINNER
• 金额: $ 167.4万
• 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 2007-02-28
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6936452
• 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，迈阿密的支出为 7,783 美元。的差异 在不同地区的生命终结模式中观察到类似的程度 护理，例如在医院死亡的机会或不同的数量 生命最后 6 个月内见过的专家。先前的研究表明 治疗上的这些地理差异很大程度上是由于差异造成的 强度，即相似患者的治疗方式的差异。 更好地了解区域差异的原因和后果 强度可能对健康和福祉产生重要影响 老年人的健康差异和财务健康 医疗保险信托基金。该项目通过以下方式解决这些问题： 1. 衡量相似疾病水平的患者如何受到不同的治疗 跨区域的总体强度和不同维度 的强度。 2. 确定强度差异的原因。到什么程度 它们是由于患者对护理的偏好、医生的信念还是其他因素造成的？ 为什么老年患者在某些地区是常态，而在另一些地区则不然 经历广泛的 CAD 诊断测试，以及后续下游 程序、专家转诊和住院治疗？ 3. 研究医疗保健强度加大的后果。什么是 更高强度的护理对生存、健康等结果的影响 更普遍的功能和福祉？ 4. 寻求了解不同地区或地区的医疗保健强度如何 随着时间的推移，会影响不同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研究团队，包括 DAWG 的调查员人数；港口；缅因州医疗中心；中心 马萨诸塞州波士顿的调查研究；马萨诸塞州总医院；和 国家经济研究局。