Optimal & Equitable Care: Medicaid Data Research Infrastructure

最佳的

• 批准号: 8016135
• 负责人: GEORGE S RUST
• 金额: $ 99.41万
• 依托单位: MOREHOUSE SCHOOL OF MEDICINE
• 依托单位国家: 美国
• 财政年份: 2010
• 资助国家: 美国
• 起止时间: 2010-09-30 至 2012-09-29
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8016135
• 关键词: Optimal; Equitable; Care; Medicaid; Data

DESCRIPTION (provided by applicant): Purpose: This is a Data Capacity-Building Project, to build a robust comparative effectiveness research infrastructure, agenda, and collaborative partnerships focused on eliminating health disparities. Specifically we will build a database comprised of all Medicaid enrollees and claims in the states that share in common both adverse minority health outcomes and the historical roots of racial health disparities in the South. Setting & Participants: Our CMS data request has already been approved and we have actually purchased (but not yet received) a 100% sample of four years (2004-07) of Medicaid Analytic Extract (MAX-file) data (plus Medicare-linked claims for dual-eligibles) from fourteen southern states, representing 3.8 to 5.4 million persons each year (one-third of all U.S. Medicaid enrollees, nearly half [48%] of African American and 21 % of Latino Medicaid enrollees in the U.S). This region is the epicenter of the black-white health disparities epidemic, and has also experienced a recent and rapid influx of Latino immigrants. Our HBCU-based team has previously had extensive experience training health services researchers (especially minority investigators) to use Medicaid claims data for research, but we currently lack the personnel and infrastructure support needed to efficiently organize and analyze these data to support minority investigators. Specific Alms: Using Medicaid Claims Data: 1. To build a Medicaid claims data set (including socio-economic, contextual, and geospatial analytic variables, NDC cross-walk data and therapeutic class codes, as well as certain Medicare data for dualeligibles) to support projects focused on the intersection between disparities research and comparative effectiveness research in clinically and socially complex patient populations. 2. To create an efficient process for assisting non-Morehouse investigators to develop research protocols, analysis plans, CMS data re-use requests, and analytic files for collaborative research. 3. To train, develop, cultivate, and support emerging minority investigators (especially at HBCUs and other minority-serving institutions) as independently-funded health services researchers who are increasingly proficient in multivariate analysis of Medicaid and Medicare claims data. 4. Cultivate comparative effectiveness and disparities research collaborations with Georgia Tech experts in mathematics, complexity science, simulation modeling, and interactive computing. PUBLIC HEALTH RELEVANCE: Medicaid patients are characterized by clinical and social complexity - the very characteristics that often exclude them from clinical trials and yet drive health disparities. This Medicaid based data set will populate studies that help us understand how local-area, provider-level, and patient-level differences in treatment (natural experiments in comparative effectiveness) influence clinical and economic outcomes. Variation implies that disparities are not inevitable. The comparative impact of this natural variation can be measured in meaningful outcomes such as emergency department visits, hospital admissions, inpatient bed-days, deaths, and total Medicaid expenditures, as well as community-level disparity rate-ratios. Medicaid data allow us to follow a complex patient (e.g., co-morbid diabetes and schizophrenia or COPD and CHF) from treatment to outcomes through every billable service in the healthcare system {i.e., from doctor's visit to lab tests to prescriptions to emergency room visits or hospital admissions). Morehouse School of Medicine has a unique ability to develop a new cadre of minority investigators to conduct and interpret the results of health services research with a racially-sensitive, culturally-competent perspective.

描述（由申请人提供）：目的：这是一个数据能力建设项目，以建立强大的比较有效性研究基础设施，议程和协作伙伴关系，旨在消除健康差异。具体而言，我们将建立一个由所有医疗补助参与者组成的数据库，并在各州共有共同的少数民族健康成果和南方种族健康差异的历史根源。 设置和参与者：我们的CMS数据请求已经批准，我们实际上已经购买（但尚未收到）四年（2004-07）的100％样本（2004 - 07年）的Medicaid Analytic Tractrive（Max-File）数据（加上与Medicare链接的双重企业索赔）从14个南部各州进行，每年3.8至540万人（每年3.8至540万人）（每年21％）在美国的拉丁裔医疗补助参与者的％）。该地区是黑白健康差异流行的中心，并且还经历了最近迅速涌入的拉丁裔移民。我们的HBCU团队以前曾拥有丰富的经验培训卫生服务研究人员（尤其是少数派研究人员）来使用医疗补助索赔数据进行研究，但我们目前缺乏有效组织和分析这些数据所需的人员和基础设施支持，以支持少数派研究人员。 具体施舍：使用Medicaid索赔数据：1。建立医疗补助索赔数据集（包括社会经济，上下文和地理空间分析变量，NDC交叉步行数据和治疗类别代码，以及对双旅行者的某些医疗保险数据），以支持项目对差异的相互作用的互动研究和比较研究的相互作用研究和临床研究和社会上的相对性研究和社会上的互动性研究。 2。创建一个有效的过程，以协助非知识的调查人员制定研究协议，分析计划，CMS数据重复使用请求和协作研究分析文件。 3。培训，发展，培养和支持新兴的少数群体研究人员（尤其是在HBCUS和其他少数族裔服务机构），作为由独立资助的卫生服务研究人员，他们越来越精通医疗补助和医疗保险索赔数据的多变量分析。 4。与佐治亚州科技，复杂性科学，仿真建模和交互式计算方面的比较有效性和差异研究合作。 公共卫生相关性：医疗补助患者的特征是临床和社会复杂性 - 通常将其排​​除在临床试验之外，但会导致健康差异。该基于医疗补助的数据集将填充研究，以帮助我们了解本地地区，提供者级别和患者水平的治疗差异（比较有效性的自然实验）如何影响临床和经济结果。变化意味着差异不是不可避免的。这种自然差异的比较影响可以在有意义的结果中衡量，例如急诊科，住院，住院床日，死亡和医疗补助总支出以及社区级别的差距比率。医疗补助数据使我们能够跟随一名复杂的患者（例如，合并症糖尿病和精神分裂症或COPD和CHF），从治疗到结局，通过医疗系统中的每项可计费服务{即，从医生的访问到实验室检查到处方到处方到急诊室就诊或住院或住院或住院或住院或住院）。 Morehouse医学院具有开发新的少数群体研究人员干部的独特能力，可以通过种族敏感，具有文化敏感的观点来进行和解释卫生服务研究的结果。

项目成果

Diversity in academic medicine no. 3 struggle for survival among leading diversity programs.

学术医学的多样性没有。

• DOI: 10.1002/msj.20081
• 发表时间: 2008
• 期刊: The Mount Sinai journal of medicine, New York
• 作者: Strelnick,AHal;Taylor,VeraS;Williams,Beverly;Lee-Rey,Elizabeth;Herbert-Carter,Janice;Fry-Johnson,YvonneW;Smith,QuentinT;Rust,George;Kondwani,Kofi
• 通讯作者: Kondwani,Kofi

Racial/ethnic disparities, social support, and depression: examining a social determinant of mental health.

种族/民族差异、社会支持和抑郁：检查心理健康的社会决定因素。

• 发表时间: 2012
• 期刊: Ethnicity & disease
• 影响因子: 3.2
• 作者: Shim,RuthS;Ye,Jiali;Baltrus,Peter;Fry-Johnson,Yvonne;Daniels,Elvan;Rust,George
• 通讯作者: Rust,George

Perceptions of health care communication: examining the role of patients' psychological distress.

对医疗保健沟通的看法：检查患者心理困扰的作用。

• DOI: 10.1016/s0027-9684(15)30779-3
• 发表时间: 2010
• 期刊: Journal of the National Medical Association
• 影响因子: 3.3
• 作者: Ye,Jiali;Shim,Ruth
• 通讯作者: Shim,Ruth

Potential savings from increasing adherence to inhaled corticosteroid therapy in Medicaid-enrolled children.

增加参加医疗补助的儿童对吸入皮质类固醇治疗的依从性可能会节省费用。

• 发表时间: 2015
• 期刊: The American journal of managed care
• 作者: Rust,George;Zhang,Shun;McRoy,Luceta;Pisu,Maria
• 通讯作者: Pisu,Maria

Individual and county level predictors of asthma related emergency department visits among children on Medicaid: A multilevel approach.

• DOI: 10.1080/02770903.2016.1196367
• 发表时间: 2017-01-02
• 期刊: The Journal of asthma : official journal of the Association for the Care of Asthma
• 作者: Baltrus P;Xu J;Immergluck L;Gaglioti A;Adesokan A;Rust G
• 通讯作者: Rust G