Home Health, ADRD, Telehealth, and Patient Outcomes

家庭健康、ADRD、远程医疗和患者结果

• 批准号: 10513268
• 负责人: DANA B MUKAMEL
• 金额: $ 72.79万
• 依托单位: UNIVERSITY OF CALIFORNIA-IRVINE
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-09-01 至 2026-06-30
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10513268
• 关键词: Acceleration; Address; Adopted; Adoption; Advocate; Alzheimer' s Disease; Biological Monitoring; Blood; Bluetooth; COVID-19; COVID-19 pandemic; Caregivers; Caring; Case Mixes; Characteristics; Chronic Obstructive Pulmonary Disease; Communication; Congresses; Data; Data Reporting; Data Sources; Dementia; Family; Future; Health; Heart Diseases; Home; Home Care Services; Home Health Agency; Home Health Care Agencies; Industry; Link; Measures; Medicare; Medicare claim; Methodology; Modality; Monitor; Natural experiment; Occupational Therapy; Outcome; Ownership; Oxygen; Patient Monitoring; Patient-Focused Outcomes; Patients; Pattern; Penetration; Persons; Physical therapy; Policies; Policy Maker; Population; Prevalence; Provider; Reporting; Risk; Services; Statistical Data Interpretation; Stroke; Surveys; Technology; Testing; Visit; Voice; base; cohort; coronavirus disease; cost; evidence base; experience; handheld mobile device; hospice environment; improved; insight; member; patient home care; payment; remote patient monitoring; telehealth; telehealthcare; traditional care; transmission process; trend; video visit; virtual visit; wound treatment

PROJECT SUMMARY/ABSTRACT Close to 40% of home health patients have been identified as persons with Alzheimer’s Disease or Related Dementias (ADRD). As the prevalence of ADRD in the population in general is expected to double by 2050, so will the percent of patients with ADRD treated by home health agencies. During the Covid-19 pandemic many home health agencies have begun using telehealth technologies, including virtual visits and biomonitoring, to augment and partially substitute in-person, traditional care. This is an acceleration of a trend that began over a decade earlier. A survey has found that by July of 2020, 49% of agencies used some form of telehealth. These two emerging trends, the expected increase in patients with ADRD on the one hand and the increased penetration and utilization of TH by HHAs on the other, raise questions about whether the two are compatible. Can home health care provided via telehealth to patients with ADRD be as good as the care provided to these patients in person? Would it be comparable in terms of patients’ health outcomes and patients’ experience? These questions have not been addressed to-date. Furthermore, there is no information about the type of agencies that adopted telehealth, and in particular among those agencies that care for a majority of ADRD patients. There is also no information about the differences in types of telehealth technologies (e.g. communication telehealth versus biomonitoring) that were adopted. This study will address these questions by: 1.) performing a national survey of home health agencies caring for a majority of patients with ADRD about their telehealth capabilities and use, and the timing of telehealth adoption; 2.) linking survey data to agency characteristics, patients’ health outcomes and patients’ experience data; 3.) analyzing the data statistically to identify agency characteristics associated with different stages of telehealth adoption, the association between telehealth and better patients’ health outcomes and experiences, and the relative ranking of specific telehealth technologies in terms of their association with better patients’ health outcomes and better patients experiences. The information gained in this study will inform home health patients and families, advocates, the industry and CMS, as the issue of payment for telehealth services for home health is moving forward towards consideration by Congress and will influence federal and state policies in the coming years.

项目总结/摘要 近40%的家庭健康患者已被确定为患有阿尔茨海默病或相关疾病的人。 痴呆症（ADRD）。由于ADRD在总人口中的患病率预计到2050年将翻一番， 家庭健康机构治疗的ADRD患者的百分比。 在2019冠状病毒病大流行期间，许多家庭医疗机构开始使用远程医疗技术， 包括虚拟访问和生物监测，以加强和部分取代面对面的传统护理。这是 这是一个十多年前开始的趋势的加速。一项调查发现，到2020年7月，49%的 机构使用某种形式的远程保健。 这两个新出现的趋势，一方面预期ADRD患者增加， 另一方面，HHA对TH的渗透和利用，提出了两者是否相容的问题。 通过远程医疗向ADRD患者提供的家庭医疗保健是否与向这些患者提供的医疗保健一样好？ 患者本人？在患者的健康结果和患者的体验方面是否具有可比性？ 这些问题迄今尚未得到解决。 此外，没有关于采用远程保健的机构类型的信息，特别是 在那些照顾大多数ADRD患者的机构中。也没有关于 远程保健技术类型的差异（例如通信远程保健与生物监测）， 领养的 本研究将通过以下方式解决这些问题：（1）进行一项全国性的家庭保健机构调查， 大多数ADRD患者了解他们的远程医疗能力和使用，以及远程医疗的时间 收养; 2.）将调查数据与机构特征、患者健康结果和患者经验联系起来 数据; 3.对数据进行统计分析，以确定与不同阶段相关的机构特征， 远程医疗的采用，远程医疗与更好的患者健康结果和体验之间的关联， 以及特定远程医疗技术在与更好的患者健康相关方面的相对排名， 健康结果和更好的患者体验。 这项研究中获得的信息将告知家庭健康患者和家庭，倡导者，行业和 CMS，因为家庭保健远程保健服务的支付问题正在考虑之中 这一政策将在未来几年影响联邦和州的政策。