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Association Between Quality of Care for Diabetes and Medically Complex Conditions

糖尿病护理质量与复杂医学病症之间的关联

基本信息

批准号：
7085262
负责人：
LESLIE J CONWELL
金额：
$ 3.17万
依托单位：
JOHNS HOPKINS UNIVERSITY
依托单位国家：
美国
项目类别：
财政年份：
2006
资助国家：
美国
起止时间：
2006-09-01 至 2007-05-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/7085262
关键词：
chronic disease /disorder clinical research comorbidity diabetes mellitus therapy disease /disorder prevention /control health care personnel performance health care quality health care service availability health services research tag human data human therapy evaluation longitudinal human study patient care management

项目摘要

DESCRIPTION (provided by the applicant): Objective: To examine the association between the presence of medically complex comorbidities and the receipt of high-quality preventive care in persons with diabetes. Background: For persons with diabetes, high-quality care includes receipt of preventive services. Researchers have examined patient and provider characteristics associated with the receipt of preventive services for diabetes. However, despite the high prevalence of comorbidities among people with diabetes, little is known about whether receipt of preventive services is associated with chronic comorbidities that require complex care. Methods: This study will analyze cross-sectional and longitudinal data from the 2000-2002 Medical Expenditure Panel Survey, a nationally representative survey of the U.S. civilian, noninstitutionalized population. The study population was over the age of 18, had diabetes, and completed a survey on disease treatment and severity. The dependent variables will be based on self-reported receipt of preventive services. The main independent variable will be the presence of medically complex conditions, which are chronic conditions that are prevalent in the population and that an expert panel identifies as requiring complex treatment. Control variables will include predisposing, enabling, and need characteristics. The first study hypothesis is that among persons with diabetes, chronic comorbidities that have a high level of medical complexity are associated with not receiving preventive services for diabetes mellitus, after adjusting for predisposing, enabling, and need characteristics. The second study hypothesis is that among persons with diabetes, chronic comorbidities that have a high level of medical complexity are associated with consistently low quality of preventive care over a 2-year period, after adjusting for predisposing, enabling, and need characteristics. Significance: This study will provide greater understanding of the challenges of providing high-quality care to persons with diabetes and medically complex comorbidities, thus addressing the Public Health Service's of Healthy People 2010 goals and the Agency for Healthcare Research and Quality's mission of improving quality of care, particularly for persons needing chronic health care.

描述（由申请人提供）：目的：检查糖尿病患者中存在医学复杂合并症与接受高质量预防性护理之间的相关性。背景：对于糖尿病患者，高质量的护理包括接受预防性服务。研究人员检查了与接受糖尿病预防服务相关的患者和提供者特征。然而，尽管糖尿病患者合并症的患病率很高，但人们对接受预防性服务是否与需要复杂护理的慢性合并症相关知之甚少。研究方法：本研究将分析2000-2002年医疗支出小组调查的横截面和纵向数据，该调查是一项针对美国平民、非住院人口的全国代表性调查。研究人群年龄在18岁以上，患有糖尿病，并完成了关于疾病治疗和严重程度的调查。因变量将基于自我报告的预防服务接受情况。主要的独立变量将是医学上复杂的疾病的存在，这些疾病是人口中普遍存在的慢性疾病，专家小组认为需要复杂的治疗。控制变量将包括倾向性、使能性和需求特征。第一个研究假设是，在糖尿病患者中，在调整了易感性、使能性和需求特征后，具有高水平医学复杂性的慢性合并症与未接受糖尿病预防服务相关。第二个研究假设是，在糖尿病患者中，具有高水平医学复杂性的慢性合并症与2年内持续低质量的预防性护理相关，调整了易感性，启用和需求特征。重要性：这项研究将使人们更好地了解为糖尿病和医学上复杂的合并症患者提供高质量护理的挑战，从而实现公共卫生服务的健康人2010年目标和医疗保健研究和质量机构的使命，即提高护理质量，特别是对需要慢性医疗保健的人。