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Effect of Dementia Caregiver Interventions on Healthcare Cost

痴呆症护理人员干预对医疗费用的影响

基本信息

批准号：
8892954
负责人：
LINDA O. NICHOLS
金额：
$ 16.99万
依托单位：
UNIVERSITY OF TENNESSEE HEALTH SCI CTR
依托单位国家：
美国
项目类别：
财政年份：
2013
资助国家：
美国
起止时间：
2013-09-30 至 2017-06-30
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/8892954
关键词：
Address Adoption African American Aging Alzheimer&apos s Disease Behavior Behavior Therapy Caregiver Burden Caregivers Caring Caucasians Characteristics Clinical Clinical Data Confounding Factors (Epidemiology)Cost Savings Data Dementia Economics Elderly Ethnic Origin Ethnic group Expenditure Funding Goals Health Health Care Costs Healthcare Healthcare Systems Hispanics Home environment Incentives Intervention Knowledge Latino Measures Medicare Medicare claim Mental Depression National Institute of Nursing Research National Institute on Aging Outcome Participant Patient Care Patients Physicians Quality of life Race Randomized Controlled Trials Reporting Resources Site Socioeconomic Status Time Translations Veterans Visit arm base caregiving clinical practice comparison group coping cost health care service utilization improved racial and ethnic successful intervention therapy design treatment as usual

项目摘要

DESCRIPTION (provided by applicant): Although behavioral interventions for dementia caregivers have been shown to decrease caregiver stress and burden, there has been little examination of their effects on healthcare costs for patients or caregivers. This lack of information on interventions' impact on healthcare costs, particularly for dementia patients, has likely impeded widespread adoption of successful interventions. The proposed study addresses important knowledge gaps in our understanding of whether a successful behavioral intervention for caregivers has an impact on actual healthcare costs for patients and caregivers and whether those impacts vary based on caregiver and patient characteristics. Our main study goal is to conduct a cost identification analysis to determine if there are healthcare cost savings for dementia patients associated with their caregivers' participation in a successful behavioral intervention to improve their own coping and patient management. We will also examine whether participation in the intervention results in healthcare use and cost savings for caregivers. We propose to integrate patient and caregiver data from two previous studies of successful behavioral interventions for dementia caregivers with Medicare and VA healthcare use and cost data. The first study was the national randomized controlled trial Resources for Enhancing Alzheimer's Caregiver Health (REACH II), conducted from 2000 to 2003, with 642 caregiving dyads from 5 sites. The second study was the national clinical translation of REACH II into the Department of Veterans Affairs healthcare system, REACH VA, with 127 dyads from 29 sites, conducted from 2007-2009. For the REACH II data, half the caregivers received the behavioral intervention designed to assist with their own coping and the management of the patient's dementia related behaviors; the other half received usual care. For each patient, we will examine Medicare healthcare use (e.g., physician visits) and their associated costs for one year before the intervention, for the time during the intervention, and for one year after the intervention. Use and costs will be compared for patients whose caregivers received the intervention vs. those who did not and for caregivers who received the intervention vs. those who did not. For the REACH VA study, all caregivers received the intervention. Both VA and Medicare use and costs will be compared for the patients whose caregivers received the intervention vs. a matched comparison group of other VA patients with dementia. For all groups, we will determine if use and costs are different for different types of patients and caregivers (e.g., those of different races or ethnicities).

描述(申请人提供)：尽管对痴呆症照顾者的行为干预已被证明可以减轻照顾者的压力和负担，但很少有人研究它们对患者或照顾者的医疗费用的影响。缺乏关于干预措施对医疗成本的影响的信息，特别是对痴呆症患者来说，可能阻碍了成功干预措施的广泛采用。这项拟议的研究解决了我们在理解对照顾者的成功行为干预是否会对患者和照顾者的实际医疗成本产生影响，以及这些影响是否会因照顾者和患者特征而异的重要知识空白。我们的主要研究目标是进行成本识别分析，以确定痴呆症患者的医疗成本是否因照顾者参与成功的行为干预而节省，以改善他们自己的应对和患者管理。我们还将研究参与干预是否会导致医疗保健的使用和照顾者的成本节约。我们建议将患者和照顾者的数据与联邦医疗保险和退伍军人管理局的医疗保健使用和成本数据相结合，这些数据来自之前两项针对痴呆症照顾者的成功行为干预研究。第一项研究是国家随机对照试验资源促进阿尔茨海默氏症照顾者健康(REACH II)，从2000年到2003年进行，来自5个地点的642名照顾双亲。第二项研究是REACH II进入退伍军人事务部医疗保健系统REACH VA的全国临床翻译，从2007年到2009年进行，有来自29个地点的127个二元体。对于REACH II数据，一半的照顾者接受了旨在帮助他们自己应对和管理患者痴呆症相关行为的行为干预；另一半接受了常规护理。对于每个患者，我们将检查干预前一年、干预期间和干预后一年的Medicare医疗保健使用情况(例如，医生就诊)及其相关费用。将对接受干预的患者和未接受干预的患者以及接受干预的患者和未接受干预的患者的使用和成本进行比较。在REACH VA研究中，所有照顾者都接受了干预。将对接受干预的患者的VA和联邦医疗保险的使用和成本进行比较，并与其他VA痴呆症患者的匹配对照组进行比较。对于所有群体，我们将确定不同类型的患者和照顾者(例如，不同种族或民族的患者)的使用和费用是否不同。

项目成果

期刊论文数量（2）

专著数量（0）

科研奖励数量（0）

会议论文数量（0）

专利数量（0）

Impact of the REACH II and REACH VA Dementia Caregiver Interventions on Healthcare Costs.

DOI：
10.1111/jgs.14716
发表时间：
2017-05
期刊：
Journal of the American Geriatrics Society
影响因子：
6.3
作者：
Nichols LO;Martindale-Adams J;Zhu CW;Kaplan EK;Zuber JK;Waters TM
通讯作者：
Waters TM

Reply to: Over-REACHing Conclusions.

回复：过度得出结论。

DOI：
10.1111/jgs.14984
发表时间：
2017
期刊：
Journal of the American Geriatrics Society
影响因子：
6.3
作者：
Nichols,LindaO;Martindale-Adams,Jennifer;Zhu,CarolynW;Kaplan,ErinK;Zuber,JeffreyK;Lum,Jessica;Waters,TeresaM
通讯作者：
Waters,TeresaM