Effect of Hospital and Community Care Coordination on Health Care Quality and Equity among Individuals with Risk Factors or Diagnosis of ADRD

医院和社区护理协调对有 ADRD 危险因素或诊断的个体的医疗保健质量和公平性的影响

• 批准号: 10353407
• 负责人: Jie Chen
• 金额: $ 49.41万
• 依托单位: UNIV OF MARYLAND, COLLEGE PARK
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-03-01 至 2024-02-29
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10353407
• 关键词: Address; Adoption; Affect; African American population; Age; Aging; Alzheimer' s Disease; Alzheimer' s disease diagnosis; Alzheimer' s disease related dementia; Alzheimer' s disease risk; American; American Hospital Association; Area; Caregivers; Caring; Chronic Care; Chronic Disease; Communities; Community Health; Community Hospitals; Community Surveys; Continuity of Patient Care; Data; Data Set; Databases; Dementia; Diabetes Mellitus; Diagnosis; Disease; Disease Progression; Ensure; Face; Feasibility Studies; Goals; Health; Health Care Costs; Health Personnel; Health Promotion; Health Resources; Health system; Healthcare Systems; Hispanic Populations; Homelessness; Hospitals; Housing; Hypertension; Individual; Investments; Latino Population; Link; Longitudinal Studies; Medicare; Medicare claim; Mental Health; Mission; National Health Interview Survey; Obesity; Organizational Models; Outcome; Patient-Centered Care; Patients; Persons; Policies; Policy Maker; Population; Primary Health Care; Public Health; Quality of Care; Reduce health disparities; Research; Resources; Risk Factors; Service delivery model; Services; Skilled Nursing Facilities; Social Work; Structure; Surveys; System; Time; U.S. Department of Housing and Urban Development; Underserved Population; United States National Center for Health Statistics; acute care; base; beneficiary; care coordination; comorbidity; cost effective; data infrastructure; design; disparity reduction; economic incentive; effective care management; ethnic minority; ethnic minority population; experience; health assessment; health care availability; health care delivery; health care quality; improved; innovation; interest; modifiable risk; population health; programs; racial and ethnic disparities; racial disparity; racial minority; racial minority population; social health determinants; supported housing

Project Summary: Addressing racial and ethnic disparities in ADRD through the integration of local public health departments and health systems is a strategic priority, according to The National Plan to Address Alzheimer's Disease 2019. Such integration is expected to address social determinants of health and promote culturally-valid population health assessments and treatment. Investments in care coordination practices and innovative health care delivery models, such as Accountable Care Organizations (ACOs), represent an important opportunity for promoting continuity of care for people with ADRD and risk factors for ADRD. There is an urgent need to understand effective care coordination practices for racial and ethnic minority ADRD patients across hospital, community, and public health systems, and how to improve such coordination systematically through innovative health care delivery models. Our long-term goal is to build a hospital-community integrated system that delivers personalized patient-centered care to promote population health and reduce health disparities for people with ADRD and risk factors for ADRD. The objective of this project is to identify hospital- community care coordination practices and the innovative features of health care delivery models that can improve effective management of ADRD; control/reduce modifiable risk factors of; and eventually promote population health and reduce health disparities. Our central hypothesis is that integrating hospital and community care with the support of ongoing policy initiatives that promote the adoption of care coordination, such as ACOs, can significantly improve health care quality and equity. We are particularly interested in understanding how care coordination can improve care quality for racial and ethnic minorities. An additional population of interest is among the hardest-to-reach populations: racial and ethnic minorities who receive federal housing assistance (through the Department of Housing and Urban Development (HUD)) and who may have experienced periods of homelessness. We aim to identify hospital-community care coordination practices that can improve quality of care, reduce health care costs, and reduce racial and ethnic disparities (Aim 1); determine the extent to which ACO models can promote care coordination practices and reduce disparities among Medicare beneficiaries with ADRD and beneficiaries who are at an increased risk for ADRD (Aim 2); and estimate the impact of care coordination practices and ACO models on health care quality and disparities reduction among HUD-assisted populations with ADRD and populations who are at an increased risk for ADRD (Aim 3). Our aims are formulated on the basis of our preliminary findings produced under current NIA support (R56AG062315). The results of our study are expected to provide evidence on cost-effective care coordination practices that can make care integration sustainable for racial and ethnic minority populations, and break down longstanding silos and bridge the gap between hospitals, health care providers, and the public health system for people with ADRDs and risk factors of ADRDs.

项目摘要：通过当地公众的整合来解决ADRD的种族和种族差异 卫生部门和卫生系统是一个战略优先事项，根据国家的解决 2019年阿尔茨海默氏病。预计这种融合将解决健康的社会决定因素并促进 具有文化valid人群健康评估和治疗。对护理协调实践的投资和 创新的医疗保健交付模型，例如责任护理组织（ACO），代表 为ADRD和ADRD危险因素促进护理连续性的重要机会。有 迫切需要了解种族和少数民族患者的有效护理协调实践 整个医院，社区和公共卫生系统，以及如何系统地改善此类协调 通过创新的医疗保健提供模型。我们的长期目标是建立整合医院社区 提供个性化以患者为中心的护理以促进人口健康并降低健康的系统 患有ADRD的人和ADRD风险因素的差异。该项目的目的是确定医院 社区护理协调实践和医疗保健提供模型的创新特征 改善ADRD的有效管理；控制/减少可修改的风险因素；并最终促进 人口健康并减少健康差异。我们的中心假设是整合医院和 社区护理在正在进行的政策计划的支持下，促进通过护理协调的采用， 例如ACO，可以显着提高医疗保健质量和公平性。我们对 了解护理协调如何改善种族和少数民族的护理质量。另一个 感兴趣的人口是最难到达的人口之一：接受的种族和少数民族 联邦住房援助（通过住房和城市发展部（HUD）），谁可以 经历了无家可归的时期。我们旨在确定医院社区护理协调惯例 这可以提高护理质量，降低医疗保健成本并减少种族和种族差异（AIM 1）； 确定ACO模型可以在多大程度上促进护理协调实践并降低差异 在有ADRD和受益人的医疗保险受益人中，ADRD风险增加（AIM 2）； 并估计护理协调实践和ACO模型对医疗保健质量和差异的影响 与ADRD的HUD辅助人群减少和人口的减少，他们的风险增加 ADRD（AIM 3）。我们的目标是根据我们当前NIA产生的初步发现制定的 支持（R56AG062315）。期望我们的研究结果提供有关具有成本效益护理的证据 可以使种族和少数民族人口可持续的护理一体化的协调实践， 并打破长期的孤岛并弥合医院，医疗保健提供者和公众之间的差距 患有ADRD的人和ADRD的危险因素的卫生系统。