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

Increasing the Feasibility, Impact, and Equity of the Medicare Annual Wellness Visit (AWV)

提高 Medicare 年度健康就诊 (AWV) 的可行性、影响力和公平性

基本信息

批准号：
10650107
负责人：
DERJUNG M TARN
金额：
$ 65万
依托单位：
UNIVERSITY OF CALIFORNIA LOS ANGELES
依托单位国家：
美国
项目类别：
财政年份：
2023
资助国家：
美国
起止时间：
2023-08-01 至 2028-04-30
项目状态：
未结题

来源：
https://reporter.nih.gov/project-details/10650107
关键词：
Academy Address Adult Affect American Caring Communities Country Couples Data Data Coordinating Center Dedications Elderly Electronic Health Record Electronics Eligibility Determination Equity Evaluation Evidence based intervention Family Physicians Federally Qualified Health Center Fee-for-Service Plans Feedback Future Geography Goals Health Health Services Needs Health system Individual Intervention Longevity Low income Medicare Methods Morbidity - disease rate National Cancer Institute Nursing Staff Outcome Assessment Patients Persons Population Preventive Preventive Health Services Preventive care Preventive service Provider Public Health Randomized, Controlled Trials Reach, Effectiveness, Adoption, Implementation, and Maintenance Recommendation Reporting Research Resources Risk Risk Assessment Screening for cancer Services Solo Practices Time United States United States Preventative Services Task Force Vaccination Videoconferencing Visit Work community based practice design ethnic disparity ethnic diversity ethnic minority ethnic minority population evidence base health data health service use human old age (65+)implementation intervention implementation strategy improved individual patient intervention cost intervention effect intervention refinement low socioeconomic status minority patient mortality novel population health post implementation practice setting practice-based research network pragmatic trial primary care practice racial disparity racial diversity racial minority racial minority population recruit screening screening services stem tool uptake

项目摘要

Project Summary Older adults vastly underutilize evidence-based preventive health services that are proven to reduce serious illness, morbidity and mortality. In fact, fewer than half of adults aged 65 and older are up-to-date on evidence- based cancer screenings and vaccinations recommended by expert committees (e.g., the USPSTF and CDC/ACIP). Those at greatest risk for receiving poor preventive care include racial and ethnic minority groups and persons of low socioeconomic status. Yet interventions to remedy this underutilization in older adults have mostly targeted individual preventive health services, rather than the totality of services needed by patients. The 2011 Medicare establishment of the Annual Wellness Visit (AWV) is a great and underused opportunity to respond to the National Cancer Institute's calls for multilevel interventions that address both the supply and demand for vastly underutilized preventive health services. This free-to-the-patient AWV visit gives providers dedicated time to focus on preventive health services. We developed a multilevel intervention to increase AWV use that successfully increased AWV utilization in 3 small (2-5 provider) pilot practices. The intervention addresses the complexities of increasing AWVs at patient (demand for services), provider (supply of services), and practice levels. It combines electronic health record (EHR)-generated information and tools with practice redesign tools and approaches to inform providers and patients about the preventive health services needed by individual patients. This proposal's goal is to conduct a pragmatic trial to evaluate the effect of the intervention on increasing AWV and preventive health services utilization. We will implement the intervention in geographically and racially/ethnically diverse community- based practices, Federally Qualified Health Centers, and academic health system practices. Practices include small to mid-size primary care practices (including solo practices), which typically are under-represented in research. Specific aims of this study are to: 1) Evaluate the effect of the intervention on use of a) AWVs and b) USPSTF and CDC/ACIP-recommended preventive services in 3 different types of practice settings; 2) Evaluate the effect of the intervention on reducing racial/ethnic disparities in AWV utilization; and 3) Evaluate factors affecting implementation and sustainability of the intervention tools and approaches, implementation strategies, and intervention effect in diverse patient settings. Implemented via video conferencing and remote deployment of EHR tools, this low-cost intervention could easily be disseminated to small and solo practices across the country. The anticipated increase in patient use of preventive health services will improve population health and lower mortality, particularly in at-risk racial/ethnic minority patients.

项目总结