Physician Referral & Mental-Disorder Related Disparities in CABG Quality
医生转介
基本信息
- 批准号:8410139
- 负责人:
- 金额:$ 23.68万
- 依托单位:
- 依托单位国家:美国
- 项目类别:
- 财政年份:2010
- 资助国家:美国
- 起止时间:2010-07-01 至 2013-06-30
- 项目状态:已结题
- 来源:
- 关键词:
项目摘要
DESCRIPTION (provided by applicant): Medical or surgical patients with coexisting mental disorders face significant barriers to accessing appropriate health care in general, and high quality cardiac services specifically. Evidence suggests that after acute myocardial infarction, patients with mental disorders tend to under-use invasive cardiac procedures including coronary artery bypass graft (CABG) surgery. In addition, our recent work shows that patients with mental disorders (such as psychiatric disorders or substance abuse disorders), when they do receive CABG surgery, are more likely to be treated by cardiac surgeons of inferior quality of care. The mental-disorder related disparities in quality of cardiac revascularization surgery are of particular concern for the Medicare population, as over 25% older persons are suffering mental disorders, and coronary heart disease (CHD) is one of the major causes of medical morbidity and mortality in this population. In addition, over 50% of all CABG surgeries are performed each year on individuals age 65 and over. However, relatively little is known about the dynamics underlying the disparity in quality of CABG surgery received by patients with coexisting mental disorders, a medically vulnerable group who has increasingly been shown to suffer from inappropriate medical and surgical care. The purpose of the study is to contribute to the understanding of the causes that lead to these observed disparities and the related clinical and policy implications, through an examination of physician behaviors in referring patients to CABG surgery. We will analyze Medicare claims data to examine actual physician practices, in which physician behavior in referring CHD patients with and without mental disorders will be compared. Multivariate statistical regression analyses will be employed. Findings of this study will help the design of future studies that aim to inform effective policy and practice initiatives to eliminate the disparities faced by elderly patients with mental disorders and better equip policy makers to address problems in the delivery of medical care to the vulnerable, mentally ill patients.
PUBLIC HEALTH RELEVANCE: This proposed project was designed to examine the role of referring physicians in the mental-disorder related disparities in receipt of high-quality cardiac procedures among Medicare patients with coronary heart diseases.
描述(由申请人提供):患有共存精神障碍的内科或外科患者在获得适当的医疗保健方面面临重大障碍,特别是高质量的心脏服务。有证据表明,急性心肌梗死后,精神障碍患者倾向于使用侵入性心脏手术,包括冠状动脉旁路移植术(CABG)手术。此外,我们最近的工作表明,患有精神障碍(如精神疾病或药物滥用障碍)的患者在接受CABG手术时,更有可能接受护理质量较差的心脏外科医生的治疗。与精神障碍有关的心脏血管重建手术质量的差异是医疗保险人群特别关注的问题,因为超过25%的老年人患有精神障碍,冠心病是这一人群发病率和死亡率的主要原因之一。此外,每年有超过50%的CABG手术是在65岁及以上的人群中进行的。然而,相对知之甚少的动态基础上接受CABG手术的质量与共存的精神障碍,医学上的弱势群体,越来越多地被证明是遭受不适当的医疗和手术护理的患者的差异。本研究的目的是通过检查医生在转介患者接受CABG手术时的行为,帮助理解导致这些观察到的差异的原因以及相关的临床和政策影响。我们将分析医疗保险索赔数据,以检查实际的医生的做法,其中医生的行为,指冠心病患者与不精神障碍将进行比较。将采用多元统计回归分析。这项研究的结果将有助于设计未来的研究,旨在告知有效的政策和实践举措,以消除老年精神障碍患者所面临的差距,并更好地装备决策者,以解决在提供医疗服务的弱势,精神病患者的问题。
公共卫生关系:本项目旨在研究转诊医生在冠心病患者接受高质量心脏手术的精神障碍相关差异中的作用。
项目成果
期刊论文数量(1)
专著数量(0)
科研奖励数量(0)
会议论文数量(0)
专利数量(0)
Are AMI patients with comorbid mental illness more likely to be admitted to hospitals with lower quality of AMI care?
- DOI:10.1371/journal.pone.0060258
- 发表时间:2013
- 期刊:
- 影响因子:3.7
- 作者:Cai X;Li Y
- 通讯作者:Li Y
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YUE LI其他文献
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{{ truncateString('YUE LI', 18)}}的其他基金
Family care to nursing home residents and state essential caregiver programs during the COVID-19 pandemic: impact on dementia care, outcomes, and disparities
COVID-19 大流行期间对疗养院居民的家庭护理和州基本护理人员计划:对痴呆症护理、结果和差异的影响
- 批准号:
10727881 - 财政年份:2023
- 资助金额:
$ 23.68万 - 项目类别:
Impact of state HCBS generosity on dementia outcomes and disparities
国家 HCBS 慷慨对痴呆症结果和差异的影响
- 批准号:
10461867 - 财政年份:2020
- 资助金额:
$ 23.68万 - 项目类别:
Impact of state HCBS generosity on dementia outcomes and disparities
国家 HCBS 慷慨对痴呆症结果和差异的影响
- 批准号:
10265545 - 财政年份:2020
- 资助金额:
$ 23.68万 - 项目类别:
Impact of state HCBS generosity on dementia outcomes and disparities
国家 HCBS 慷慨对痴呆症结果和差异的影响
- 批准号:
10091228 - 财政年份:2020
- 资助金额:
$ 23.68万 - 项目类别:
Impacts of nursing home competition & state policies on disparities in quality
疗养院竞争的影响
- 批准号:
8993872 - 财政年份:2013
- 资助金额:
$ 23.68万 - 项目类别:
Impacts of nursing home competition & state policies on disparities in quality
疗养院竞争的影响
- 批准号:
8476905 - 财政年份:2013
- 资助金额:
$ 23.68万 - 项目类别:
Physician Referral & Mental-Disorder Related Disparities in CABG Quality
医生转介
- 批准号:
8092591 - 财政年份:2010
- 资助金额:
$ 23.68万 - 项目类别:
Physician Referral & Mental-Disorder Related Disparities in CABG Quality
医生转介
- 批准号:
7781269 - 财政年份:2010
- 资助金额:
$ 23.68万 - 项目类别:
State Nursing Home Technical Assistance Programs: Variation & Impact on Quality
国家疗养院技术援助计划:变化
- 批准号:
7752039 - 财政年份:2008
- 资助金额:
$ 23.68万 - 项目类别:
State Nursing Home Technical Assistance Programs: Variation & Impact on Quality
国家疗养院技术援助计划:变化
- 批准号:
8423223 - 财政年份:2008
- 资助金额:
$ 23.68万 - 项目类别:
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