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

Do State Regulations Affect the Outcomes of Assisted Living Residents with Dementia?

州法规会影响患有痴呆症的辅助生活居民的结果吗？

基本信息

批准号：
9917897
负责人：
Kali St. Marie Thomas
金额：
$ 28.98万
依托单位：
BROWN UNIVERSITY
依托单位国家：
美国
项目类别：
财政年份：
2018
资助国家：
美国
起止时间：
2018-01-15 至 2020-12-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/9917897
关键词：
Accident and Emergency department Address Admission activity Adverse effects Advocate Affect Alzheimer&apos s Disease Alzheimer&apos s disease related dementia Assisted Living Facilities Behavior Caring Cessation of life Communities Cross-Sectional Studies Data Dementia Diagnosis Elderly Ensure Environment Exploratory/Developmental Grant for Diagnostic Cancer Imaging Goals Health Home Nursing Care Hospitalization Impaired cognition Individual Industry Interview Investigation Licensing Long-Term Care Longitudinal Studies Measures Medicare Medicare claim Methodology Methods Modeling National Institute on Aging Nursing Homes Outcome Personal Satisfaction Policies Population Provider Quality of Care Recording of previous events Regulation Research Research Personnel Role Standardization Surveys Testing United States National Center for Health Statistics Vulnerable Populations base beneficiary care outcomes care providers cohort community living dementia care experience falls improved improved outcome informant innovation lens meetings novel payment residential care facility response

项目摘要

PROJECT SUMMARY/ABSTRACT Approximately one million individuals, an estimated 40-72% with cognitive impairment or a diagnosis of Alzheimer’s disease-related dementias (ADRD), reside in assisted living (AL); yet, little is known about their experience or the quality of care offered. Unlike other forms of long-term care (LTC), such as nursing homes that are federally regulated, the licensing, operating, and enforcement requirements for AL falls to the states, which vary dramatically in their approaches to regulating this growing industry. As AL assumes an increased role in providing LTC to vulnerable older adults with ADRD, there is an urgent need to understand the positive and negative effects of state regulations on quality of care. Our long-term goal is to improve care outcomes for AL residents, with a specific emphasis on residents with ADRD who often cannot advocate for themselves. The overall objective of this application is to examine states’ AL regulatory environments and understand if and how the health outcomes of AL residents with ADRD are impacted by states’ regulatory decisions. The central hypothesis is that in order to survive, AL providers adhere to licensing requirements and respond to changes in the regulatory environment, which ultimately impact AL residents’ outcomes. The rationale for the proposed research is that better understanding the experiences of AL residents with ADRD and how they vary based on a state’s approach to regulating this industry will help to inform policy and payment decisions and ultimately improve the outcomes of older adults with ADRD needing LTC. Guided by strong preliminary data, this hypothesis will be tested by pursuing three specific aims: 1) Characterize how states regulate AL as it relates to the care of residents with ADRD; 2) Test the effect of regulations on providers’ responses and outcomes of AL residents with ADRD; 3) Compare outcomes between residents with ADRD who reside in ALs licensed to provide specialized dementia care to residents in non-specialized ALs. Under the first aim, investigators will build on their previous efforts to identify and examine the history, oversight, and enforcement of states’ AL regulations likely to impact outcomes of residents with ADRD. In the second aim, investigators will apply a novel methodology they developed through an R21 from the National Institute on Aging (#R21AG047303) to identify AL residents using Medicare data and with rigorous methods examine the effect of regulatory changes on providers’ behaviors and residents’ outcomes over a 10-year period. Under the third aim, investigators will apply an observational, quasi-experimental methodology to examine the effect of living in a dementia- specialized AL on residents’ outcomes. This approach is innovative because it is the first to examine the outcomes of AL residents with ADRD, nationally, and the impact of the widely varying AL regulations on healthcare outcomes. The proposed research is significant because it will provide valuable information to states as they seek the most effective ways to regulate this growing industry. Ultimately, such information has the potential to improve the outcomes of vulnerable older adults with ADRD who utilize AL.

项目总结/文摘