Understanding Diabetic Eye Disease in the Underserved Using Health Data Exchange

使用健康数据交换了解服务不足的地区的糖尿病眼病

• 批准号: 8769287
• 负责人: DUSTIN D. FRENCH
• 金额: $ 22.8万
• 依托单位: NORTHWESTERN UNIVERSITY AT CHICAGO
• 依托单位国家: 美国
• 财政年份: 2014
• 资助国家: 美国
• 起止时间: 2014-09-30 至 2016-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8769287
• 关键词: Academic Medical Centers; Accounting; Adult; African American; Age; Area; Blindness; Blood Vessels; Caring; Centers for Disease Control and Prevention (U.S.); Chicago; Cities; Clinical; Clinical Data; Collaborations; Communities; Community Health Services; Comprehensive Health Care; Country; County Hospitals; Data; Databases; Demographic Factors; Detection; Diabetes Mellitus; Diabetic Retinopathy; Diagnosis; Disease; Epidemiology; Extravasation; Eye; Eye diseases; Faculty; Federally Qualified Health Center; Funding; Future; General Population; Geographic Locations; Goals; Health; Healthcare; Healthcare Systems; Hemorrhage; Hispanics; Incidence; Individual; Infusion procedures; Institution; Insurance; Intervention; Lead; Liquid substance; Location; Low Income Population; Low income; Medical; Medical center; Medicine; Minority; Modeling; National Eye Institute; Ophthalmic examination and evaluation; Ophthalmologist; Ophthalmology; Optometrist; Patient Care; Patients; Persons; Population; Populations at Risk; Prevalence; Public Health; Reporting; Research; Resources; Retina; Safety; Services; Severity of illness; Site; Strategic Planning; Swelling; System; Techniques; Testing; Time; Underrepresented Minority; Uninsured; United States; Universities; Veterans; Vision Disorders; Vision research; base; cooking; cost effective; data exchange; diabetic; diabetic patient; disorder prevention; health disparity; health information technology; innovation; insight; low socioeconomic status; macula; metropolitan; new growth; prevent; programs; public health relevance; repository; safety net; screening; socioeconomics; surgical service; tool

DESCRIPTION (provided by applicant): The overall objective of this proposal is identify and compare Federally Qualified Health Centers (FQHC) eye care screening and treatment for diabetic retinopathy while controlling for an array of socio-economic, demographic and other related factors. Diabetes is the leading cause of blindness among United States (US) adults 40 years and older. Little is known about the prevalence of diabetic retinopathy in the growing US minority, low-income, and uninsured population. Chicago is the third most populous city in the US and comprises 2.7 million people within the city limits, and approximately 10 million in the metropolitan area. It includes multiple world class medical centers, over 70 distinct communities and most segregated areas associated with some of the largest health disparities in the country. The FQHCs are community-based organizations that provide standardized comprehensive care services to persons of all ages, regardless of their ability to pay, and are a critical component o the health care safety net. Many FQHC patients are minorities, do not have insurance, and would otherwise lack access to basic medical care. Providing insight into screening, diagnosis, and treatment (if any) will help to identify areas with greatest need for immediate intervention. The highly innovative Chicago Health Information Technology Regional Extension Center (CHITREC) is an existing database and offers the opportunity to track individual patients (over 2 million in the city of Chicago) across the fragmented health care system to better understand diabetic eye disease, screening, and treatments in the underserved and minorities. Our aims seek to identify all patients in CHITREC with a diagnosis of diabetes and classify them into three groups (non-FQHC utilization group, FQHC utilization without the presence of an ophthalmologist or optometrist, and FQHC utilization with the presence of an ophthalmologist or optometrist) and assess the difference in the rates of annual eye exams, disease detection, and treatment among these three groups. Aim 1 will estimate the number of diabetics with an annual eye care exam and Aim 2 will estimate the diabetic retinopathy detection, treatment rate and time to treatment. We will use descriptive techniques and regression models to study utilization and treatments accounting for the site and location, socio-economic, and demographic factors. This proposal allows for the strategic planning with analyses aimed at identifying the areas with the greatest need for the planned placement and infusion of additional ophthalmologists and resources directed at ameliorating the identified health disparities. Subsequently we shall test the use of non-mydratic cameras as an equivalence trial as a long-term cost effective screening strategy for the underserved patients identified and analyzed.

描述（由申请人提供）：本提案的总体目标是确定和比较联邦合格卫生中心（CNOHC）对糖尿病视网膜病变的眼部护理筛查和治疗，同时控制一系列社会经济、人口统计学和其他相关因素。糖尿病是美国（US）40岁及以上成年人失明的主要原因。糖尿病视网膜病变的患病率在不断增长的美国少数民族，低收入和无保险的人口知之甚少。芝加哥是美国人口第三多的城市，市区内有270万人，大都市区约有1000万人。它包括多个世界级的医疗中心，70多个不同的社区和与该国一些最大的健康差距相关的最隔离的地区。社区保健中心是以社区为基础的组织，向所有年龄的人提供标准化的综合保健服务，而不论其支付能力如何，是保健安全网的一个重要组成部分。许多少数民族残疾人健康保险患者是少数民族，没有保险，否则将无法获得基本医疗服务。提供对筛查、诊断和治疗（如果有的话）的深入了解将有助于确定最需要立即干预的领域。高度创新的芝加哥健康信息技术区域推广中心（CHITREC）是一个现有的数据库，并提供了在分散的医疗保健系统中跟踪个体患者（芝加哥市超过200万人）的机会，以更好地了解服务不足和少数民族的糖尿病眼病，筛查和治疗。我们的目标是确定CHITREC中所有诊断为糖尿病的患者，并将其分为三组（非眼科医生或验光师使用的眼科医生或验光师），并评估这三组之间年度眼科检查，疾病检测和治疗率的差异。目标1将估计每年进行眼科护理检查的糖尿病患者人数，目标2将估计糖尿病视网膜病变检测、治疗率和治疗时间。我们将使用描述性技术和回归模型来研究利用和治疗占网站和位置，社会经济和人口因素。该提案允许进行战略规划和分析，旨在确定最需要计划安排和注入更多眼科医生和资源的领域，以改善已确定的健康差距。随后，我们将测试使用非mydratic相机作为等效性试验，作为一个长期的成本效益筛选策略，为服务不足的患者确定和分析。