Partnerships Between Medicaid, Tumor Registries & Cancer Control Researchers

医疗补助、肿瘤登记处之间的合作伙伴关系

• 批准号: 8531893
• 负责人: Deborah Schrag
• 金额: $ 11.8万
• 依托单位: DANA-FARBER CANCER INST
• 依托单位国家: 美国
• 财政年份: 2012
• 资助国家: 美国
• 起止时间: 2012-08-16 至 2017-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8531893
• 关键词: 21 year old; Academia; Adjuvant; Age; Agreement; American; California; Cancer Center; Cancer Control; Cancer Etiology; Cancer Patient; Caring; Charge; Childhood; Chronic; Chronic Care; Collaborations; Complex; Data; Data Linkages; Data Sources; Diagnosis; Educational process of instructing; Effectiveness; Employment; Enrollment; Environment; Ethnic Origin; Excess Mortality; Eye; Faculty; Feedback; Fostering; Government; Health; Health Care Reform; Health Insurance; Health Personnel; Health Services; Health Services Research; Healthcare; Healthcare Systems; Hormonal; Hormone Receptor; Hospitals; Indigent Care; Institution; Insurance; Insurance Carriers; Insurance Coverage; Intervention; Intervention Studies; Leadership; Life; Malignant Neoplasms; Measures; Medicaid; Medical Oncologist; Medical Records; Medicare/Medicaid; Medicine; Mentors; Mentorship; Minority Groups; Modeling; Nature; New York; Outcome; Palliative Care; Patients; Persons; Pharmacoepidemiology; Physicians; Population; Poverty; Provider; Public Health; Public Health Schools; Publications; Quality of Care; Race; Research; Research Infrastructure; Research Methodology; Research Personnel; Research Project Grants; Resources; Senior Scientist Award; Social Class; Solid Neoplasm; Solutions; Staging; State Children' s Health Insurance Program; Students; Surveys; System; Testing; Training; Translating; Treatment outcome; Update; Woman; Work; base; beneficiary; cancer care; cancer therapy; cancer type; care delivery; career; career development; chemotherapy; design; disability; follow-up; genetic linkage analysis; health disparity; hormone therapy; improved; innovation; malignant breast neoplasm; medical schools; member; mortality; neoplasm registry; next generation; population health; professor; programs; racial and ethnic disparities; skills; therapy design; tool; tumor registry

DESCRIPTION (provided by applicant): This K05 proposal will support Dr. Schrag's efforts to train the next generation of health services researchers in cancer control and establish partnerships with state public health departments that leverage information from linkages between tumor registry, Medicaid and Medicare data. She will augment established linkages between these data sources in New York and California to evaluate quality and effectiveness of cancer care, identify priorities for intervention studies and pilot test feedback systems. Candidate Qualifications: Dr. Schrag is a medical oncologist and health services researcher and an Associate Professor of Medicine at Harvard Medical School. She also has an MPH from the Harvard School of Public Health. She has an accomplished research record, a current R01 directly relevant to the proposed work, and a successful teaching and mentorship track record. Career Development: Dr. Schrag seeks to enhance her already well developed health services research methods expertise through focused coursework in geospatial analysis and advanced pharmacoepidemiology. She seeks to cultivate her leadership skills to foster partnerships with state health departments and pursue externships to solidify these collaborations. Mentorship Objectives: Dr. Schrag proposes to dedicate 25% effort to mentorship and 10% to a complementary set of research projects that focus on care delivery for Medicaid insured cancer patients. She will train pre/postdoctoral students at Harvard, at neighboring institutions and in the New York State health department in health services research methods and quality improvement. Career Objectives: * To decrease the magnitude of disparities based on race and class by focusing on cancer care delivery for persons enrolled in Medicaid programs, the primary health insurer for Americans living in poverty. * To evaluate the effectiveness of new cancer treatments as they are used by patients living with challenges created by poverty and/or chronic disability. * To develop intervention strategies that improve cancer treatment for patients who have the largest gaps between actual and attainable treatment outcomes. * To develop sustainable strategic partnerships between providers (hospitals and physicians), researchers and health departments responsible for oversight of public insurance programs and population health. Research Project Objectives: Innovative, High Impact and Well Integrated with Mentorship Plans 1. Expand Capacity for Tumor Registry-Medicaid-Medicare Data Linkages to Evaluate Cancer Care * Update the NY and CA data linkages to include more recent cases with longer follow-up * Extend the NYS data linkages to include the pediatric population * Measure agreement between medical records and Medicaid administrative data * Develop tools that facilitate use of Medicaid data linkages by other investigators 2. Evaluate the Quality and Effectiveness of Care for Medicaid Recipients with Cancer * Evaluate use and outcomes of hormonal and chemotherapy for early stage breast cancer * Evaluate palliative care for patients with advanced solid tumors 3. Identify Specific Mechanisms that Explain Shortcomings and Design Interventions to Improve Care * Survey Medicaid enrollees about reasons for their underuse of care with known efficacy * Provide health care providers with data about care delivery for their Medicaid patients * Pilot capacity of feedback loops between NYS Medicaid, its enrollees and providers to improve care Environment: Dana-Farber/Harvard: The collaborative research program of the Dana-Farber/Harvard Cancer Center brings together seven institutions including the Harvard Schools of Medicine and Public Health. Dr. Schrag and her mentees have access to the wealth of resources at these institutions, including computing, space, training, cores, and expert research faculty. Research will be carried out in close collaboration with the New York State Department of Health's (NYSDOH) Cancer Registry and Medicaid leadership. The DFCI-NYSDOH partnership will take place via regular calls, webinars and trips to Albany, NY. Innovation and Impact: This work is innovative because it will develop an important but underutilized resource, train users and build its capacity as a launching pad for quality improvement. The proposed work is high impact because it will prioritize problems, identify solutions, and create sustainable infrastructure to improve care in NY, CA. This model can be adapted by other states invested in population health.

描述（由申请人提供）：该K 05提案将支持Schrag博士努力培训下一代癌症控制方面的卫生服务研究人员，并与州公共卫生部门建立合作伙伴关系，利用肿瘤登记，医疗补助和医疗保险数据之间的联系信息。她将加强纽约和加州这些数据源之间的联系，以评估癌症护理的质量和有效性，确定干预研究和试点测试反馈系统的优先事项。 候选人资格：Schrag博士是医学肿瘤学家和卫生服务研究员，也是哈佛医学院的医学副教授。她还拥有哈佛公共卫生学院的公共卫生硕士学位。她有一个完成的研究记录，目前的R 01直接相关的拟议工作，以及成功的教学和指导跟踪记录。 职业发展：Schrag旨在通过地理空间分析和高级药物流行病学的重点课程来增强她已经发展良好的卫生服务研究方法专业知识。她寻求培养自己的领导能力，以促进与国家卫生部门的伙伴关系，并追求externships巩固这些合作。 师友计划目标：Schrag博士建议将25%的精力用于指导，10%用于一系列补充研究项目，这些项目专注于为医疗补助保险的癌症患者提供护理。她将在哈佛、邻近的机构和纽约州卫生部门培训博士前/博士后学生，学习卫生服务研究方法和质量改进。 职业目标： * 通过关注参加医疗补助计划的人的癌症护理服务，减少基于种族和阶级的差异的程度，医疗补助计划是生活在贫困中的美国人的主要健康保险公司。 * 评估新的癌症治疗方法的有效性，因为它们被生活在贫困和/或慢性残疾带来的挑战中的患者使用。 * 制定干预策略，改善实际和可达到的治疗结果之间差距最大的患者的癌症治疗。 * 发展供应商（医院和医生），研究人员和负责监督公共保险计划和人口健康的卫生部门之间的可持续战略伙伴关系。 研究项目目标：创新，高影响力和良好的导师计划相结合 1.扩大肿瘤登记-医疗补助-医疗保险数据链接的能力，以评估癌症护理 * 更新NY和CA数据链接，以纳入随访时间更长的最新病例 * 扩展NYS数据链接，以包括儿科人群 * 医疗记录和医疗补助管理数据之间的一致性 * 开发便于其他研究者使用Medicaid数据链接的工具 2.评估癌症医疗补助接受者的护理质量和有效性 * 评价激素和化疗在早期乳腺癌中的使用和结局 * 评估晚期实体瘤患者的姑息治疗 3.确定解释短缺的具体机制并设计干预措施以改善护理 * 调查医疗补助登记者，了解他们未充分利用已知疗效的护理的原因 * 向医疗保健提供者提供有关其Medicaid患者的护理交付的数据 * 纽约州医疗补助计划、其注册者和提供者之间的反馈回路试点能力，以改善护理 工作环境：丹娜-法伯/哈佛：丹娜-法伯/哈佛癌症中心的合作研究项目汇集了包括哈佛医学院和公共卫生学院在内的七个机构。Schrag博士和她的学员可以获得这些机构的丰富资源，包括计算，空间，培训，核心和专家研究人员。研究将与纽约州卫生部（NYSDOH）癌症登记处和医疗补助领导层密切合作。DFCI-NYSDOH合作伙伴关系将通过定期电话、网络研讨会和纽约州奥尔巴尼之旅进行。 创新与影响：这项工作具有创新性，因为它将开发一种重要但利用不足的资源，培训用户，并建设其作为提高质量跳板的能力。拟议的工作具有很大的影响力，因为它将优先考虑问题，确定解决方案，并创建可持续的基础设施，以改善加利福尼亚州纽约市的护理。其他投资于人口健康的州可以采用这种模式。