权益分类	功能权益	普通用户	{{item.name}}会员
{{category.name}}	{{benefitItem.name}}

Predicting and Preventing Hospital Readmission in Patients with Diabetes and CVD

预测和预防糖尿病和心血管疾病患者再入院

基本信息

批准号：
8891852
负责人：
Daniel J Rubin
金额：
$ 17.16万
依托单位：
TEMPLE UNIV OF THE COMMONWEALTH
依托单位国家：
美国
项目类别：
财政年份：
2015
资助国家：
美国
起止时间：
2015-04-01 至 2019-02-28
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/8891852
关键词：
Accounting Address Admission activity Area Boston Calibration Cardiovascular Diseases Caring Clinical Clinical Research Clinical Trials Community Health Nurse Specialist Community Health Nursing Data Diabetes Mellitus Discrimination Education Electronics Evaluation Research Evidence based practice General Hospitals Glycosylated hemoglobin A Goals Health Care Costs Health Care Reform Hospital Costs Hospitalization Hospitals Hypoglycemia Information Technology Inpatients Intervention Knowledge Lipids Massachusetts Measures Medical center Mentors Mentorship Methods Minority Participant Patient Care Patient Education Patients Pharmaceutical Preparations Phase Pilot Projects Population Prevention Randomized Controlled Trials Records Research Research Personnel Research Training Resources Risk Risk Reduction Structure Techniques Testing Time Training United States United States Dept. of Health and Human Services University Hospitals Urban Population Woman Work arm base career career development clinical practice cohort cost diabetes mellitus therapy diabetic patient economic cost glycemic control health care quality high risk hospital readmission improved indexing novel patient oriented pilot trial population health predictive modeling prevent public health relevance research and development skills socioeconomic disparity statistics therapy design tool urban area

项目摘要

DESCRIPTION (provided by applicant): The overall goal of this K23 proposal is to train Daniel J. Rubin, MD, MSc for a career as an independent investigator in the prediction and prevention of hospital readmission among patients with diabetes. Readmissions within 30 days of discharge (30d readmissions) are a high-priority quality measure and target for cost reduction. Patients with diabetes and cardiovascular disease (CVD) are disproportionately over- represented in 30d readmissions, especially among racial minorities and urban populations. Currently there is no validated method to identify diabetic patients admitted for CVD at the highest risk of 30d readmission, which is a critical prerequisite for targeting limited resources fr reducing readmission risk to those most in need. Furthermore, there are no proven interventions to reduce the risk of 30d readmission specifically among patients with diabetes. Dr. Rubin plans to address these gaps in knowledge with 2 aims, 1) validating and refining a Diabetes Early Readmission Risk Index (DERRI-CVD) for predicting 30d readmission risk in diabetic patients admitted for CVD, and 2) assessing the feasibility and acceptability of a novel, multifactorial intervention designed to reduce 30d readmissions. The intervention adapts methods successfully used in other inpatient populations to diabetic patients hospitalized for CVD and will target those identified as high risk for readmission based on the DERRI-CVD. There are 2 Phases to the proposed research that address these aims: Phase 1 uses a new retrospective cohort of diabetic patients to validate and refine the DERRI-CVD for prediction of 30d readmission risk; Phase 2 involves a single-arm pilot trial to qualitatively assess the feasibility and acceptability of the intervention. In order to successfully complete the proposed research and build on skills to achieve the overall goal of independence, Dr. Rubin will receive additional training through formal coursework and structured mentorship in the following: validating and refining predictive models, clinical trials, and principles of hospital quality improvement with a focus on readmission prediction and prevention. A distinguished group of senior investigators will serve as mentors and advisors to supervise Dr. Rubin's research and career development. The proposed research and training will help Dr. Rubin acquire skills, establish a body of work in this area and generate preliminary data to support a competitive R01 application to test the readmission risk reduction intervention in a randomized controlled trial. Such work is highly relevant in the current era of soaring health care costs and national health care reform. This proposal will enable Dr. Rubin to develop into a successful independent investigator while improving patient care and reducing readmission disparities through clinical research.