The geography of acute care

急症护理的地理

• 批准号: 8801812
• 负责人: DOUGLAS J WIEBE
• 金额: $ 95.45万
• 依托单位: UNIVERSITY OF PENNSYLVANIA
• 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 2018-09-29
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8801812
• 关键词: geography; acute; care

 DESCRIPTION (provided by applicant): Groundbreaking federal programs including CMS's quality initiatives and AHRQ's quality and safety portfolio have increased transparency and improved the value of healthcare. The Patient Protection and Affordable Care Act have prioritized community and population health as the critical next step in the quality movement. As a result, the National Quality Forum and the Institute of Medicine have focused efforts on understanding how best to improve population health, and the Department of Health & Human Services has created a National Quality Strategy. While population health has been defined conceptually, no accountable geographic unit has been defined and thus standardized measurement of health indicators across communities cannot be measured and compared. The overall goal of this proposal is to empirically derive novel health care coalitions and their corresponding catchments that can be used to measure progress toward the achievement of population health. We will use existing Ambulatory Care Sensitive Conditions (ACSC, called Prevention Quality Indicators), the soon to be released Emergency Department Prevention Quality Indicators, and a number of Emergency Care Sensitive Conditions (ECSC) to paint a compelling portrait of the healthcare system's management of the population's acute healthcare needs. We will first identify healthcare coalitions (HCC) and their corresponding geographic catchments that empirically represent acute healthcare utilization across the United States. Then, we will evaluate the ability of healthcare coalitions (HCC) to detect meaningful variability of health indicators to facilitate comparative reporting between coalitions. Finally, we will measure variability in prevention quality indicators across healthcare coalitions and publicly disseminate statistical code and geographic shapefiles for healthcare coalitions and catchments. Healthcare facilities that share patients from overlapping neighborhoods have a shared responsibility for the needs of those who look to them in their time of need. To date, it has been difficult to measure the quality of care delivered to the population by local and regional healthcare delivery systems. The work proposed here will develop an empirically defined geographic "denominator" that describes the population for which groups of hospitals share the responsibility of population health, and this work will facilitate cooperation across the multisectoral health system.

 描述（由申请人提供）：开创性的联邦计划，包括CMS的质量倡议和AHRQ的质量和安全组合，增加了透明度，提高了医疗保健的价值。《病人保护和平价医疗法》将社区和人口健康作为质量运动的关键下一步。因此，国家质量论坛和医学研究所将工作重点放在了解如何最好地改善人口健康上，卫生与公众服务部制定了国家质量战略。虽然从概念上界定了人口健康，但没有界定负责的地理单位，因此无法衡量和比较各社区健康指标的标准化计量。本提案的总体目标是根据经验得出新的卫生保健联盟及其相应的流域，可用于衡量实现人口健康的进展。我们将使用现有的门诊护理敏感条件（ACSC，称为预防质量指标），即将发布的急诊科预防质量指标，以及一些紧急护理敏感条件（ECSC）来描绘医疗保健系统对人口急性医疗保健需求的管理的令人信服的肖像。我们将首先确定医疗联盟（HCC）及其相应的地理流域，经验代表整个美国的急性医疗保健利用。然后，我们将评估医疗保健联盟（HCC）检测健康指标的有意义的变化，以促进联盟之间的比较报告的能力。最后，我们将测量医疗联盟之间预防质量指标的变化，并公开传播医疗联盟和流域的统计代码和地理形状文件。医疗保健机构从重叠的社区共享病人，对那些在需要时向他们寻求帮助的人的需求负有共同责任。到目前为止，很难衡量地方和区域向人口提供的护理质量， 医疗保健提供系统。在此提出的工作将制定一个经验界定的地理“分母”，说明各医院集团分担人口保健责任的人口，这项工作将促进跨部门卫生系统的合作。