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

Medicare Advantage Plan Choice and Selection Among Racial and Ethnic Minorities and Low-Income Seniors

少数族裔和低收入老年人的医疗保险优势计划选择和选择

基本信息

批准号：
10361431
负责人：
Maricruz Rivera-Hernandez
金额：
$ 12.58万
依托单位：
BROWN UNIVERSITY
依托单位国家：
美国
项目类别：
财政年份：
2019
资助国家：
美国
起止时间：
2019-07-15 至 2024-03-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/10361431
关键词：
Accounting Address Adult Affect African American population Aging Alzheimer&apos s disease related dementia Area Award Caring Clinical Clinical Trials Cognitive Complex Data Decision Making Decision Theory Dementia Development Development Plans Economics Elderly Enrollment Ensure Environment Ethnic Origin Faculty Family Family member Gerontology Goals Health Health Care Research Health Insurance Health Personnel Health Policy Health Services Health Services Research Healthcare Hispanic Populations Home Impaired cognition Individual Insurance Intervention Interview Investigation Lead Literature Low income Medicare Medicare Part C Mentored Research Scientist Development Award Mentors Methods Modeling Nursing Homes Outcome Patients Persons Policies Policy Maker Population Population Heterogeneity Positioning Attribute Process Psychiatrist Public Health Quality of Care Race Research Research Activity Research Design Research Methodology Research Personnel Resources Structure Testing Training Training Activity Universities Vulnerable Populations base behavioral economics beneficiary career career development cognitive ability cost dementia care design econometrics ethnic minority experience federal policy health care settings health service use innovation insight low socioeconomic status member multidisciplinary preference programs racial and ethnic racial minority research and development socioeconomic disadvantage success tool

项目摘要

ABSTRACT I am an ethnic minority gerontologist-health services researcher at the Department of Health Services, Policy, and Practice and the Center for Gerontology and Healthcare Research at Brown University. The purpose of this K01 proposal is to provide me with the additional training and research experience necessary to become an independent investigator studying health insurance decision-making among vulnerable seniors with Alzheimer’s disease and Related Dementias (ADRD). Since these individuals may have more difficulty making complex decisions, it is imperative that we better understand how they choose a Medicare Advantage (MA) plan and why they choose to disenroll. My training plan focuses on five interrelated aims to develop expertise in models and theory of decision-making among seniors with and without ADRD, behavioral economics and econometric methods, consumer choice in healthcare and policy environment, mixed-methods research, and design of decision-supportive interventions for older adults with and without ADRD. To achieve these goals, I have assembled a team of mentors and collaborators from a multi-disciplinary group of established researchers and practical research experience that addresses my training needs. The team is led by Amal Trivedi, MD., a health services researcher with experience in MA and the impact of benefit plan design on health services use and outcomes experienced by Medicare beneficiaries. Co-mentors and advisors include: Dr. Momotazur Rahman, an expert in the economics of aging and how patients’ choice affect health outcomes; Dr. Renee Shield, an expert in conducting qualitative and mixed-methods research in different health care settings; Dr. Steven Sloman, an expert in decision-making; Dr. Gary Epstein-Lubow, a psychiatrist and an expert in ADRD and dementia care; and Dr. Vincent Mor, an expert in implementing and evaluating interventions and clinical trials. My training activities have been integrated with the following Specific Aims to understand the insurance decision-making processes among people with and without dementia: 1) To determine quality of choice of MA plans among vulnerable groups with and without dementia; 2) To analyze switching among vulnerable populations with different types of dementia enrolled in MA plans; 3) To qualitatively describe how seniors with and without dementia switch and disenroll from MA and how they make their next choice. Brown University offers an outstanding environment for scientific research in Gerontology and Health Services Research, and numerous opportunities for professional development. The faculty members leading this research are dedicated mentors committed to the success of trainees. This department has given me its strongest support for my continued training and research activities during the award period. At the K01 nears conclusion, I will be well-positioned to submit a competitive R01 during Year 4 that will propose an intervention to facilitate optimal decision making in various stages of ADRD and strategies for simplifying choices for health insurance and treatment-related decisions for older adults, and individuals with dementia.

摘要我是布朗大学卫生服务、政策和实践部以及老年学和医疗保健研究中心的少数民族老年学-卫生服务研究员。这个K 01提案的目的是为我提供必要的额外培训和研究经验，使我成为一名独立调查员，研究老年痴呆症和相关痴呆症（ADRD）患者的健康保险决策。由于这些人可能更难做出复杂的决定，因此我们必须更好地了解他们如何选择Medicare Advantage（MA）计划以及他们选择退出的原因。我的培训计划侧重于五个相互关联的目标，以发展在有和没有ADRD的老年人决策模型和理论方面的专业知识，行为经济学和计量经济学方法，医疗保健和政策环境中的消费者选择，混合方法研究，以及为有和没有ADRD的老年人设计决策支持干预措施。为了实现这些目标，我组建了一个由多学科研究人员和实践研究经验组成的导师和合作者团队，以满足我的培训需求。该团队由医学博士Amal Trivedi领导，一位具有MA经验的卫生服务研究人员，以及福利计划设计对医疗保险受益人使用卫生服务和结果的影响。共同导师和顾问包括：Momotazur Rahman博士，老龄化经济学以及患者的选择如何影响健康结果的专家; Renee Shield博士，在不同卫生保健环境中进行定性和混合方法研究的专家; Steven Sloman博士，决策专家;加里Epstein-Lubow博士，精神病学家和ADRD和痴呆症护理专家;文森特莫尔博士是实施和评估干预措施和临床试验的专家。我的培训活动已经与以下具体目标相结合，以了解痴呆症患者和非痴呆症患者的保险决策过程：1）确定痴呆症患者和非痴呆症患者的弱势群体对MA计划的选择质量; 2）分析MA计划中不同类型痴呆症的弱势群体之间的转换; 3）定性描述老年痴呆症和非痴呆症患者如何从MA转换和退出，以及他们如何做出下一步选择。布朗大学为老年学和卫生服务研究的科学研究提供了良好的环境，并为专业发展提供了许多机会。领导这项研究的教师是致力于学员成功的导师。在获奖期间，该部门对我继续进行培训和研究活动给予了最有力的支持。在K 01接近尾声时，我将有能力在第4年提交一份有竞争力的R 01，该报告将提出一项干预措施，以促进ADRD各个阶段的最佳决策，并提出简化老年人健康保险和治疗相关决策选择的策略，以及痴呆症患者。