Population Based Research in Geriatric Palliative Care

老龄化是我们历史上最大的公共卫生挑战之一。到2030年，美国20%的人口 人口将在65岁以上，这是患癌症、心脏病、痴呆症和其他疾病的最高精算风险群体 慢性、复杂的疾病。老年姑息治疗是一种跨学科的护理，其重点是提供缓解 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。 与严重疾病有关；与照顾3500多万人有关的压力和负担 作为重病患者的非正式照顾者；以及未能提供适当和 及时照顾患有大病的老年人及其家人。 为了解决这些问题，研究人员转向越来越多的大型、以人口为基础的 调查和行政数据集，以回答老年姑息治疗领域的相关问题。这些 大型数据集已经成为理解社会因素、卫生政策、融资系统、 组织结构和流程、社交网络和个人行为会影响患者和照顾者 结果、获得医疗保健的机会、医疗质量和成本，以及随时间和时间的医疗模式 在易受伤害的亚群中。单站点和小型多站点研究通常无法招收足够大的 抽样以研究具有广泛诊断、并存疾病和功能限制或 由于基本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 收集。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 以及老年姑息治疗的临床实践。然而，这类观测的方法论挑战 大量研究包括复杂的纵向数据、分层结构、信息缺失的数据 由于死亡或辍学、代理受访者和复杂的调查加权设计。 因此，当务之急是建立一个研究计划，吸引、培训和支持一个可持续的 正在进行的、严格进行的、基于人群的研究的老年姑息治疗研究人员。因此， 奥尔德里奇博士正在寻求学术领导事业奖，以发展基于人群的研究 西奈山老年姑息治疗计划。该计划将培训老年姑息治疗 研究人员将复杂的研究和统计方法应用于其他领域，但不常见 应用于老年姑息治疗研究，并开发可持续的研究基础设施，以支持新的 对人口感兴趣的教职员工、研究员、住院医生和医学生的几代研究人员 基础研究。奥尔德里奇博士一直站在培训和传播研究方法的前沿 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，奥尔德里奇博士是唯一有资格成功实现该奖项目标的人。

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.