Optimization modeling and comparative effectiveness of regionalized stroke care

区域化脑卒中护理的优化建模及效果比较

• 批准号: 8308960
• 负责人: CHARLES C. BRANAS
• 金额: $ 40.77万
• 依托单位: UNIVERSITY OF PENNSYLVANIA
• 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 2014-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8308960
• 关键词: Optimization; modeling; comparative; effectiveness; regionalized

PROJECT TITLE: OPTIMIZATION MODELING AND COMPARATIVE EFFECTIVENESS OF REGIONALIZED STROKE CARE PI: CHARLES CHRISTOS BRANAS, PHD Abstract: In the United States, stroke is the leading cause of serious, long-term disability and the third leading cause of death. Every 40 seconds someone experiences a stroke and every 3-4 minutes someone dies from a stroke. The projected national direct and indirect cost of stroke for 2008 is $65.5 billion. In 2002, a landmark study demonstrated a marked improvement in outcomes for patients treated with medical therapy within 3 hours of symptom onset. Despite this, as of 2004, between 1% and 3% of victims of ischemic stroke were receiving the definitive therapy. Certification of primary stroke centers by the joint commission began in 2003, and treatment at a definitive stroke center has been associated with improved outcomes. The broad objective of this proposal is to use operations research techniques to promote the development of optimized regional stroke systems and to compare the effectiveness of different regionalization schemes to improve population access to stroke center care. The specific aims of this proposal are 1) to use geographic information systems technology to determine the proportion of the US population that is able to rapidly access existing, definitive stroke center hospital care in all 50 states and the District of Columbia, 2) to use geographic information systems and models describing emergency medical transportation to compare the ability of competing regionalization schemes to rapidly deliver patients to existing stroke center hospitals in all 50 states and the District of Columbia, 3) to create an operations research model that simulates the optimal distribution of stroke center hospitals and air ambulances in order to maximize rapid access to specialized stroke care in all 50 States and the District of Columbia, & 4) to use geographic information systems and models describing emergency medical transportation to compare population access to definitive stroke center care using the existing distribution of US stroke center hospitals compared to the optimal distribution of stroke center hospitals in all 50 states and the District of Columbia. We will present our findings at the level of the state in both mathematical and visual format. This study has the capacity to inform the further development of the US stroke system, and in so doing, to optimize the delivery of definitive stroke care to the population.

项目名称： 区域化卒中护理的优化建模和比较效果 PI：查尔斯·克里斯托斯·布拉纳斯，博士 抽象的： 在美国，中风是导致严重、长期残疾的主要原因，也是导致严重、长期残疾的第三大原因。 死亡。每 40 秒就有一人中风，每 3-4 分钟就有一人死于中风。 预计 2008 年全国因中风造成的直接和间接损失为 655 亿美元。 2002年，一项具有里程碑意义的研究 事实证明，接受药物治疗的患者在 3 小时内的治疗结果有显着改善 症状发作。尽管如此，截至 2004 年，仍有 1% 至 3% 的缺血性中风患者接受了 明确的治疗。联合委员会于 2003 年开始对初级卒中中心进行认证，治疗 在明确的卒中中心治疗与改善预后相关。本次活动的总体目标 建议利用运筹学技术促进优化区域行程的发展 系统并比较不同区域化计划的有效性，以改善人口获得服务的机会 中风中心护理。本提案的具体目标是 1) 使用地理信息系统技术 确定能够快速进入现有的、明确的中风中心的美国人口比例 所有 50 个州和哥伦比亚特区的医院护理，2) 使用地理信息系统和 描述紧急医疗运输的模型，以比较竞争性区域化的能力 计划将患者快速运送到所有 50 个州和华盛顿特区的现有中风中心医院 哥伦比亚，3）创建模拟中风中心最佳分布的运筹学模型 医院和空中救护车，以便在所有 50 个州最大限度地快速获得专门的中风护理服务 哥伦比亚特区，&4) 使用地理信息系统和模型描述紧急情况 医疗运输，利用现有的医疗运输系统来比较人群获得明确的中风中心护理的情况 美国卒中中心医院分布与全球卒中中心医院最佳分布的比较 50 个州和哥伦比亚特区。我们将在州一级展示我们的研究结果 数学和视觉格式。这项研究有能力为美国的进一步发展提供信息 中风系统，从而优化向人群提供明确的中风护理服务。