Alcohol Use and Medical Care Quality among the Elderly

老年人饮酒与医疗质量

• 批准号: 7140260
• 负责人: ELIZABETH L MERRICK
• 金额: $ 17.86万
• 依托单位: BRANDEIS UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2005
• 资助国家: 美国
• 起止时间: 2005-09-20 至 2008-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7140260
• 关键词: Medicare /Medicaid; alcoholic beverage consumption; alcoholism /alcohol abuse; behavioral /social science research tag; chronic disease /disorder; clinical research; disease /disorder prevention /control; health behavior; health care quality; health care service utilization; health insurance; health services research tag; human old age (65+); human subject; mental disorder diagnosis; mental disorders; population survey; social support network

DESCRIPTION (provided by applicant): The focus of this study is to examine the relationships between alcohol consumption, alcohol disorder diagnosis, and quality indicators for preventive and chronic medical care in elderly Medicare beneficiaries. People with substance abuse disorders often fail to receive regular health care and can be less likely to receive preventive services and treatment for chronic medical disorders. However, for the elderly population in which multiple medical needs are common, the connection between alcohol use and quality of care has not yet been fully examined. Interactions between alcohol consumption levels and diagnosis of alcohol disorders as they affect medical care quality remain similarly unexplored. Predisposing and enabling factors such as health beliefs, social support, and prescription drug coverage must also be taken into account for a full understanding of how alcohol problems may be associated with quality of care. Because administrative and self-reported data have complementary strengths, we will use data from the 1999-2003 rounds of the Medicare Current Beneficiary Survey linked with Medicare claims. This is a continuous, nationally representative survey of the Medicare population of which we will use a subset of over-65, community-dwelling beneficiaries (N=approximately 13,000 per year). This linked data set has been widely used for research and allows both cross-sectional and longitudinal analyses. The survey data includes self-reported alcohol consumption, prescription drug use, health and functional status, health beliefs, and other information. The claims data will allow us to use accepted performance measures such as the HEDIS measures developed by the National Committee for Quality Assurance for substance abuse, medical and psychiatric disorders, and preventive services to examine quality of care indicators as well as detailed utilization and cost parameters. We will address the following specific aims: 1. Determine whether and how alcohol consumption and/or diagnosis are related to receipt of recommended preventive medical services. 2. Determine whether and how alcohol consumption and/or diagnosis are related to quality indicators for selected chronic medical and psychiatric conditions. 3. Develop a summary quality indicator reflecting quality of care across various types of medical care to examine the relationship between alcohol consumption/diagnosis and "treating the whole person." This exploratory research will contribute to developing an important yet understudied area of inquiry. The results will delineate the gap between current practice and goals for care of the elderly population, identify those most at risk for both untreated substance abuse and other unmet medical needs, and identify patient and provider factors related to better performance, thus facilitating effective strategies for improving care.

描述（由申请人提供）：这项研究的重点是检查饮酒，酒精疾病诊断和质量指标与老年医疗保险受益人的预防和慢性医疗护理之间的关系。患有药物滥用障碍的人通常无法获得定期的医疗保健，并且不太可能接受慢性医疗疾病的预防服务和治疗。 但是，对于多种医疗需求很普遍的老年人群而言，尚未对酒精使用与护理质量之间的联系进行全面检查。饮酒水平与饮酒疾病的诊断之间的相互作用在影响医疗质量的情况下仍然没有探索。还必须考虑到易感性和促成因素，例如健康信念，社会支持和处方药覆盖范围，以充分了解对酒精问题如何与护理质量相关。由于行政和自我报告的数据具有互补的优势，因此我们将使用1999 - 2003年的Medicare当前受益人调查的数据，该调查与Medicare索赔有关。这是一个连续的，全国性的 对医疗保险人群的代表性调查，我们将使用一部分超过65个社区居民受益人（n =每年约13,000）。该链接的数据集已被广泛用于研究，并允许横断面和纵向分析。调查数据包括自我报告的酒精消耗，处方药的使用，健康和功能状况，健康信念和其他信息。索赔数据将使我们能够采用公认的绩效指标，例如由国家质量滥用，医学和精神疾病质量保证制定的HEDIS措施，以及预防服务来检查护理指标的质量以及详细的利用率和成本参数。我们将解决以下具体目标： 1。确定饮酒和/或诊断是否与收到推荐的预防医疗服务有关。 2.确定饮酒和/或诊断与某些慢性医学和精神病疾病的质量指标是否与饮酒和/或诊断有关。 3。制定一个摘要质量指标，反映了各种医疗服务的护理质量，以检查饮酒/诊断与“治疗整个人”之间的关系。 这项探索性研究将有助于开发一个重要但经过研究的研究领域。结果将描述当前的实践与照顾老年人的目标之间的差距，确定那些对未经治疗的药物滥用和其他未满足的医疗需求最有风险的人，并确定与更好绩效有关的患者和提供者因素，从而促进改善护理的有效策略。

项目成果

Drinking patterns of older adults with chronic medical conditions.

患有慢性疾病的老年人的饮酒模式。

• DOI: 10.1007/s11606-013-2409-1
• 发表时间: 2013
• 期刊: Journal of general internal medicine
• 影响因子: 5.7
• 作者: Ryan,Marian;Merrick,ElizabethL;Hodgkin,Dominic;Horgan,ConstanceM;Garnick,DeborahW;Panas,Lee;Ritter,Grant;Blow,FredericC;Saitz,Richard
• 通讯作者: Saitz,Richard

Older adults' inpatient and emergency department utilization for ambulatory-care-sensitive conditions: relationship with alcohol consumption.

老年人对门诊护理敏感情况的住院和急诊科使用情况：与饮酒的关系。

• DOI: 10.1177/0898264310383156
• 发表时间: 2011
• 期刊: Journal of aging and health
• 影响因子: 2.8
• 作者: Merrick,ElizabethSLevy;Hodgkin,Dominic;Garnick,DeborahW;Horgan,ConstanceM;Panas,Lee;Ryan,Marian;Blow,FredericC;Saitz,Richard
• 通讯作者: Saitz,Richard