Population Based Research in Geriatric Palliative Care

老年姑息治疗的人群研究

• 批准号: 9762808
• 负责人: MELISSA Diane ALDRIDGE
• 金额: $ 12.59万
• 依托单位: ICAHN SCHOOL OF MEDICINE AT MOUNT SINAI
• 依托单位国家: 美国
• 财政年份: 2018
• 资助国家: 美国
• 起止时间: 2018-08-15 至 2023-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9762808
• 关键词: Address; Advance Care Planning; Affect; Aging; Area; Award; Budgets; Caregivers; Caring; Cessation of life; Characteristics; Chronic; Clinical; Collaborations; Communication; Comorbidity; Complex; Consultations; Data; Data Base Management; Data Collection; Data Set; Decision Making; Dementia; Development; Diagnosis; Dropout; Economics; Educational workshop; Effectiveness; Elderly; Enrollment; Faculty; Family; Fellowship; Foundations; Funding; Generations; Geriatrics; Goals; Grant; Guidelines; Health; Health Care Costs; Health Policy; Health Services Research; Healthcare; Healthcare Systems; Heart Diseases; High Prevalence; Individual; Infrastructure; Lead; Leadership; Letters; Medical Students; Methodology; Modeling; Observational Study; Outcome; Pain; Palliative Care; Palliative Medicine; Patients; Pattern; Personal Behavior; Policies; Population; Population Research; Population Study; Process; Proxy; Public Health; Quality of life; Recording of previous events; Research; Research Infrastructure; Research Methodology; Research Personnel; Resources; Respondent; Risk; Sampling; Site; Social Network; Solid; Speed; Statistical Methods; Stress; Structure; Subgroup; Surveys; System; Techniques; Time; Training; Training Support; Vision; Weight; Work; aging population; cancer risk; care costs; career; caregiving; clinical practice; cohort; data management; design; disability; dissemination research; evidence base; experience; health care availability; health care disparity; health care quality; human old age (65+); improved; improved outcome; informal caregiver; innovation; insight; interest; medical schools; organizational structure; population based; programs; psychosocial; recruit; reduce symptoms; research data dissemination; social; social health determinants; webinar

Aging represents one of the largest public health challenges in our history. By 2030, 20 percent of the U.S. population will be over age 65, the group at highest actuarial risk of cancer, heart disease, dementia, and other chronic, complex illnesses. Geriatric palliative care is interdisciplinary care that focuses on providing relief from the symptoms and stress of serious illness with the goal of improving quality of life for older adults and families. Extensive national data demonstrate a high prevalence of physical, psychosocial, and financial suffering associated with serious illness; stress and burden related to caregiving for the more than 35 million individuals serving as informal caregivers to the seriously ill; and a healthcare system that fails to deliver appropriate and timely care to older adults with serious illness and their families. To address these issues, researchers have turned to an increasing number of large, population based survey and administrative datasets to answer pertinent questions in the field of geriatric palliative care. These large datasets have become essential to understanding how social factors, health policies, financing systems, organizational structures and processes, social networks, and personal behaviors affect patient and caregiver outcomes, access to healthcare, quality and cost of healthcare, and patterns of healthcare over time and across vulnerable subgroups. Single site and small multi-site studies are often unable to enroll a large enough sample to study individuals with a wide range of diagnoses, comorbid conditions, and functional limitations or to collect information on social determinants of health due to budgetary and time constraints of primary data collection. Existing population based studies, however, provide the opportunity to rapidly influence both policy and clinical practice in geriatric palliative care. Yet, the methodological challenges of this type of observational research are substantial including complex longitudinal data, hierarchical structures, informatively missing data due to death or dropout, proxy respondents, and complex survey-weighted designs. It is thus imperative to build a research program that attracts, trains, and supports a sustainable pool of geriatric palliative care investigators for ongoing, rigorously conducted, population based research. As such, Dr. Aldridge is seeking an Academic Leadership Career Award to develop a Population Based Research Program in Geriatric Palliative Care at Mount Sinai. This Program will train geriatric palliative care researchers to apply sophisticated research and statistical methodology used in other fields but not commonly applied to geriatric palliative care research, and develop sustainable research infrastructure to support new generations of researchers across faculty, fellows, residents, and medical students interested in population based research. Dr. Aldridge has been at the forefront of training and dissemination of research methods for observational data. As newly appointed Vice-Chair for Research and with more than a decade of experience utilizing these types of data, Dr. Aldridge is uniquely qualified to successfully achieve the aims of this award.

老龄化是我们历史上最大的公共卫生挑战之一。到2030年，20%的美国 人口将超过65岁，这一群体患癌症、心脏病、痴呆症和其他疾病的精算风险最高。 慢性复杂疾病老年姑息治疗是跨学科的护理，重点是提供救济， 严重疾病的症状和压力，目的是改善老年人和家庭的生活质量。 广泛的国家数据表明，身体、心理和经济痛苦的发生率很高 与严重疾病相关的压力和负担;超过3500万人的生活压力和负担 作为重病患者的非正式护理人员;以及未能提供适当和 及时照顾患有严重疾病的老年人及其家人。 为了解决这些问题，研究人员已经转向越来越多的大型，人口为基础的 调查和行政数据集，以回答在老年姑息治疗领域的相关问题。这些 大型数据集对于理解社会因素、卫生政策、融资系统 组织结构和流程、社交网络和个人行为影响患者和护理者 结果，获得医疗保健，医疗保健的质量和成本，以及随着时间的推移和 在弱势群体中。单中心和小型多中心研究通常无法招募足够大的 样本，以研究具有广泛诊断、共病和功能限制的个体，或 由于原始数据的预算和时间限制，收集关于健康的社会决定因素的信息 收藏.然而，现有的基于人口的研究提供了迅速影响这两项政策的机会。 和老年姑息治疗的临床实践。然而，这类观测的方法学挑战 研究是大量的，包括复杂的纵向数据，层次结构，信息缺失数据 由于死亡或辍学，代理受访者和复杂的调查加权设计。 因此，必须建立一个研究计划，吸引，培训和支持一个可持续的人才库。 老年姑息治疗研究人员正在进行的，严格进行的，以人口为基础的研究。因此，在本发明中， 博士阿尔德里奇正在寻求一个学术领导职业奖，以发展人口为基础的研究 在西奈山老年姑息治疗方案。该计划将培训老年姑息治疗 研究人员应用在其他领域使用但不常见的复杂研究和统计方法 应用于老年姑息治疗研究，并发展可持续的研究基础设施，以支持新的 几代研究人员跨越教师，研究员，居民和医学生感兴趣的人口 基于研究。阿尔德里奇博士一直站在培训和传播研究方法的最前沿， 观测数据作为新任命的研究副主席，拥有十多年的经验 利用这些类型的数据，阿尔德里奇博士是唯一有资格成功实现这一奖项的目标。