Chronic Care Management of Geriatric Traumatic Brain Injury

老年创伤性脑损伤的长期护理管理

• 批准号: 10407015
• 负责人: Monique Renae Pappadis
• 金额: $ 11.86万
• 依托单位: UNIVERSITY OF TEXAS MED BR GALVESTON
• 依托单位国家: 美国
• 财政年份: 2020
• 资助国家: 美国
• 起止时间: 2020-08-01 至 2025-05-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10407015
• 关键词: Accident and Emergency department; Accounting; Acute; Address; Administrator; Age; Area; Brain Injuries; Caregivers; Caring; Case Manager; Cessation of life; Characteristics; Chronic; Chronic Care; Chronic Disease; Communities; Continuity of Patient Care; Data; Decision Making; Development; Disease; Disease model; Elderly; Epidemic; Ethnic Origin; Evidence based intervention; Foundations; Funding; Future; Geriatrics; Goals; Health; Health Personnel; Health Policy; Health Services; Home; Home Nursing Care; Hospitalization; Hospitals; Incidence; Individual; Injury; Institutionalization; Intervention; Interview; Long-Term Care; Long-Term Care Nursing; Longevity; Medicare; Mentored Research Scientist Development Award; Mentors; Mentorship; Methodology; Methods; Modeling; Nurses; Nursing Homes; Occupational; Occupational Therapy; Outcome; Outcome Study; Patients; Pattern; Patterns of Care; Persons; Physical therapy; Physicians; Play; Primary Health Care; Process; Provider; Public Health; Quality of Care; Race; Recommendation; Research; Research Activity; Research Personnel; Research Training; Risk; Role; Severities; Social Workers; Socioeconomic Status; Speech; Speech Therapy; Structure; Symptoms; Time; Training; Training Activity; Translating; Traumatic Brain Injury; United States National Institutes of Health; Visit; acute care; advanced analytics; aged; barrier to care; base; behavioral health; care delivery; care outcomes; care providers; care systems; career; career development; clinical care; cohort; comorbidity; disability; ethnic minority; evidence base; health care delivery; health care disparity; health care service utilization; health disparity; hospital readmission; implementation science; improved; intervention mapping; medical specialties; neighborhood disadvantage; programs; satisfaction; sex; skills; sociodemographics; socioeconomic disadvantage; stakeholder perspectives; therapy development; treatment as usual

ABSTRACT Traumatic brain injury (TBI) among older adults has emerged as a new silent epidemic. Older age is associated with long-lasting symptoms and poorer outcomes after injury. A need exists for an acute-to-chronic disease model of traumatic brain injury to guide the chronic care management of older adults with TBI. Limited evidence exists on the patterns and continuity of care following discharge from acute and post-acute care to the community after TBI. This mixed-methods Mentored Research Scientist Development Award (K01) will generate data on the patterns and continuity of care to identify disparities in care and inform initiatives to improve quality of care of older adults with TBI following hospital discharge. The overarching goal of this NIA K01 award is to provide the candidate with a better understanding of the needs and provision of care of older adults with TBI, advanced analytical skills to evaluate care delivery, skills in translating evidence into health initiatives to improve care, and development of an independent research program contributing to improving health outcomes of older adults with TBI. The candidate's mentoring team includes well-established researchers in geriatric medicine, post-acute care, health services, mixed methodology, quality improvement, implementation sciences, and health disparities. The candidate will receive mentorship and training in four essential areas to achieve her career goals, which are to: (1) understand the clinical care processes and health care policies influencing health care delivery of older adults; (2) increase proficiency in advanced analytical approaches to evaluate health care delivery for older adults using administrative claims data; (3) develop, adapt, and evaluate real-world evidence-based interventions to improve health care delivery for older adults; and (4) accelerate career trajectory to becoming an NIH-funded investigator focused on improving care for older adults with TBI. Using Medicare data (2015-2018), the training activities will prepare her to address the following specific aims, which are to: (1) determine the patterns of care in older adults with TBI during the year following acute discharge; (2) explore facilitators and barriers to continuity of care, and elicit stakeholder recommendations to improve care following acute discharge among older adults with TBI, caregivers, and healthcare personnel; and (3) examine the association between continuity of care and health outcomes following acute discharge among older adults with TBI. The findings from this K01 will contribute to describing current practice, and integrate stakeholder perspectives to guide efforts to address disparities in care receipt. Through the research aims and career development training activities, the candidate will be better equipped to submit an R01 to evaluate the effect of implementing an evidence-based, patient-informed transitional care intervention to improve care continuity and health outcomes following discharge among older adults with TBI.

摘要 老年人的创伤性脑损伤（TBI）已经成为一种新的无声流行病。老年是 与受伤后的长期症状和不良后果有关。需要一种从急性到慢性的 创伤性脑损伤的疾病模型，以指导老年人TBI的慢性护理管理。有限 有证据表明，从急性和急性后护理出院后， TBI后的社区这个混合方法指导研究科学家发展奖（K 01）将 生成关于护理模式和连续性的数据，以确定护理方面的差距，并为各项举措提供信息， 提高患有脑外伤的老年人出院后的护理质量。本NIA的总体目标 K 01奖是为了让候选人更好地了解老年人的需要和提供护理 TBI成人，评估护理提供的高级分析技能，将证据转化为健康的技能 改善护理的举措，并制定一项独立的研究计划， 老年TBI患者的健康状况。候选人的辅导团队包括知名的 研究人员在老年医学，急性后护理，卫生服务，混合方法，质量改进， 实施科学和健康差距。候选人将在四年内接受指导和培训 实现其职业目标的关键领域，包括：（1）了解临床护理流程和健康 影响老年人医疗保健提供的护理政策;（2）提高高级分析能力 使用行政索赔数据评估老年人医疗保健服务的方法;（3）开发， 调整和评估现实世界的循证干预措施，以改善老年人的医疗保健服务; 和（4）加速职业轨迹，成为NIH资助的研究人员，专注于改善护理 老年人TBI使用医疗保险数据（2015-2018年），培训活动将使她做好准备， 以下具体目标，即：（1）确定年内老年TBI患者的护理模式 急性出院后;（2）探索促进和障碍，以持续的护理，并引起利益相关者 建议改善老年TBI患者、护理人员和 医疗保健人员;（3）检查护理连续性与健康结果之间的关联 在老年TBI患者急性出院后。K 01的发现将有助于描述 目前的做法，并纳入利益攸关方的观点，以指导努力解决在接受护理方面的差距。 通过研究目标和职业发展培训活动，候选人将更好地装备， 提交R 01，以评估实施循证、患者知情的过渡期护理的效果 干预措施，以改善TBI老年人出院后的护理连续性和健康结果。