Novel, High-Impact Studies Evaluating Health System and Healthcare Professional Responsiveness to COVID-19

评估卫生系统和医疗保健专业人员对 COVID-19 反应的新颖、高影响力研究

• 批准号: 10193445
• 负责人: Rebecca Sarah Etz
• 金额: $ 49.13万
• 依托单位: VIRGINIA COMMONWEALTH UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2020
• 资助国家: 美国
• 起止时间: 2020-12-11 至 2022-11-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10193445
• 关键词: Novel; Impact; Studies; Evaluating; Health

PROJECT SUMMARY FOR PEOPLE ARE PRIMARY Background: We are experiencing an event unlike any in living history. The global pandemic, referred to as “COVID-19”, has become a one-of-a-kind stress test on health care systems around the world. The size, scope, and speed of this pandemic has created an imperative for rapid dissemination of data and findings. The response of US primary care practices to COVID-19 is a large-scale natural experiment of the capacity of primary care to meet the majority of people's needs. And yet, at the start the pandemic in the US, there was no one organization, federal agency, or national dataset able to provide real-time on-the-ground data regarding the experiences of primary care practices or their patients. Purpose: On March 13, 2020, as the US declared COVID-19 a national emergency, our team created a national research Collaboratory and launched the “Quick COVID-19 Primary Care Survey” (C19 Survey) to fill that gap. The Pilot C19 Survey began as a clinician-based weekly national survey to monitor the response, challenges, and capacity of US primary care practices during the COVID-19 pandemic. After 4 weeks, we launched a complementary patient-based C19 Survey. People Are Primary would allow the C19 Surveys to continue beyond the Pilot stage. We will examine the responses, challenges, and capacity of primary care practices in order to evaluate the resilience and adaptive decision- making required during the pandemic. Drawing on both patients and clinicians, we will examine the rapid adoption of digital health by primary care as well as the positive and negative consequences of digital health on 1) access to care across varied settings, 2) patient and clinician care delivery experiences, and 3) the interaction of digital health with relationships between primary care patients and primary care teams. Methods: This is a mixed-methods learning evaluation with an exploratory sequential design. Regular surveys will be distributed to identified clinician and patient groups throughout the 2-year study period. These will begin weekly and will evolve into biweekly and then monthly surveys in response to changes in the natural evolution of the pandemic and subsequent primary care practice response. The research team will engage in weekly rapid learning cycles that complete data collection, analysis, dissemination, and adjustment to survey instrument within a 7-day period. The team will also use bimonthly deep learning cycles to develop time series and trend- based analysis, offering a more extended conversation of these findings and their implications for the long-term stability and strengthening of the US primary care platform. Benefit: The COVID-19 pandemic has exposed the costs of chronic and fragmented under-investment in primary care. Examination of the rapid adoption of digital health and its impact on patient and clinician experiences of care during the pandemic can inform a much needed strategy to 1) stop the immediate threat of primary care collapse, 2) identify practice and funding strategies able to stabilize primary care practices, and 3) enable the long term strengthening of primary care.

以人为本的项目总结为主 背景：我们正在经历一场史无前例的事件。全球大流行，被称为 新冠肺炎，已成为全球独一无二的医疗体系压力测试。大小， 这场大流行的范围和速度使迅速传播数据和研究结果成为当务之急。这个 美国初级保健实践对新冠肺炎的反应是对初级保健能力的大规模自然实验 初级保健，以满足大多数人的需求。然而，在美国大流行之初，并没有 一个组织、联邦机构或国家数据集，能够提供关于以下方面的实时实地数据 初级保健实践或其病人的经验。目的：2020年3月13日，美国宣布 新冠肺炎属于国家紧急状态，我们团队创建了国家研究合作实验室，并推出了《快速 新冠肺炎初级保健调查“(C19调查)填补了这一空白。试点C19调查最初是以临床医生为基础的 每周一次的全国调查，以监测美国初级保健实践的反应、挑战和能力 新冠肺炎大流行。4周后，我们启动了一项基于患者的补充性C19调查。人们都是 初选将允许C19调查在试点阶段之后继续进行。我们将审查这些回复， 初级保健实践的挑战和能力，以评估复原力和适应性决策- 在大流行期间做出必要的决定。根据患者和临床医生的意见，我们将检查快速 初级保健采用数字健康以及数字健康的积极和消极后果 1)跨不同环境获得护理，2)患者和临床医生的护理交付体验，以及3) 数字健康与初级保健患者和初级保健团队之间的关系的互动。方法： 这是一种探索性顺序设计的混合方法学习评价。定期检验将是 在两年的研究期间分发给确定的临床医生和患者组。这些活动将每周开始 并将演变为两周一次，然后每月一次的调查，以回应自然演变的变化 大流行和随后的初级保健实践应对。研究小组将每周进行一次快速调查 完成数据收集、分析、传播和调整调查工具的学习周期 在7天内。该团队还将使用双月深度学习周期来开发时间序列和趋势- 基于分析，提供对这些发现及其长期影响的更广泛的对话 美国初级保健平台的稳定和加强。好处：新冠肺炎大流行暴露了 初级保健长期和支离破碎的投资不足的成本。对快速采用 数字健康及其对患者和临床医生在大流行期间的护理经验的影响可以为 急需的战略1)阻止初级保健崩溃的直接威胁，2)确定实践和资金 能够稳定初级保健做法的战略，以及3)能够长期加强初级保健。