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Potential New Barriers to Home Health Access for People with Alzheimer's Disease and Related Dementias

阿尔茨海默病和相关痴呆症患者获得家庭健康的潜在新障碍

基本信息

批准号：
10689133
负责人：
Sara Knox
金额：
$ 13.78万
依托单位：
MEDICAL UNIVERSITY OF SOUTH CAROLINA
依托单位国家：
美国
项目类别：
财政年份：
2021
资助国家：
美国
起止时间：
2021-09-01 至 2026-06-30
项目状态：
未结题

来源：
https://reporter.nih.gov/project-details/10689133
关键词：
Acute Admission activity Advocacy Affect Alzheimer&apos s disease related dementia Behavioral Symptoms COVID-19 COVID-19 pandemic Career Mobility Caring Characteristics Clinical Communities Competence Complex Data Data Analyses Doctor of Philosophy Elderly Equilibrium Ethics Funding Future Goals Grouping Health Health Occupations Health Policy Health Services Research Healthcare Systems Home Home Care Services Home Health Agency Hospitalization Individual Institution Institutionalized Persons International Length Link Matched Group Measures Medical Medicare Mentors Mentorship Methods Modeling Observational Study Outcome Outcome Measure Patient Preferences Patient risk Patients Persons Physical therapy Policies Professional Competence Qualifying Quality of Care Quality of life Research Research Design Research Personnel Research Training Resources Risk Factors Scoring Method Services Source South Carolina Stress System Techniques Training Universities Vulnerable Populations acute care aging in place beneficiary billing data care costs career development college comparison group cost economic implication experience functional decline health care service health practice hospital readmission member operation pandemic disease patient population payment professor psychological symptom skills trend waiver

项目摘要

PROJECT SUMMARY/ABSTRACT Candidate: I am an assistant professor in the Division of Physical Therapy in the College of Health Professions at the Medical University of South Carolina in Charleston, South Carolina. My long-term goal is to become a well-funded, independent researcher investigating post-acute care of individuals with Alzheimer’s Disease and Related Dementias (ADRD). To achieve this goal, I will build upon my clinical expertise and current research training. For the K01 period, I have set four short term training goals/objectives: (1) Develop competence in post-acute care policy impacting people with ADRD, (2) Develop skills in management and manipulation of Medicare data of people with ADRD, (3) Develop competence in propensity score methods and data analysis for data of people with ADRD, and (4) Enhance my grantsmanship, ethical conduct of research, and mentorship skills for career development and advancement. Mentoring Team: My Primary Mentor is Kit Simpson, DrPH and my Co-Mentor is Kenneth Ottenbacher, PhD, OTR. Additional members of the mentoring team include Annie Simpson PhD, Jacobo Mintzer, MD, MBA, and Kathryn H Bowles PhD, RN, FAAN, FACMI. My mentoring team is highly qualified and includes nationally and internationally recognized experts in health services research (K. Simpson), post-acute care quality measures (K. Ottenbacher), ADRD (J. Mintzer), study design and analysis methods for observational studies (A. Simpson), and home health practice, policy, and research (K. Bowles). My mentoring team will guide career development activities and participate in the K01 research. Research Strategy: Medicare home health underwent unprecedented changes in 2020 due to the COVID-19 pandemic and a new payment model. These vast changes threaten to exacerbate existing barriers to home health access for people with ADRD. Decreased access to home health causes harm to people with ADRD and can trigger a cascade of resource and financial implications for the health care system. Impacts of the current crisis on home health access and quality for people with ADRD has not been examined but is urgently needed. This K01 project will use well matched groups, to show the impact of reimbursement change and pandemic disruption on home health access and outcomes for people with and without ADRD through analysis of Medicare assessment and billing data. Propensity score methods will be used to balance patient risk factors for comparison groups. Aim 1: Describe differences in home health access and outcomes between well- matched groups of Medicare Beneficiaries (MBs) with and without ADRD in 2019. Aim 2: Examine changes in home health access and outcomes for well-matched groups of MBs in 2019 vs 2020. Aim 3: Examine changes in home health access and outcomes for well-matched groups of MBs in 2019 vs 2021. Findings from this study can help to optimize access, cost, and outcomes for people with ADRD and the Medicare system and inform advocacy efforts, current home health practice, and future post-acute care policies.

项目摘要/摘要候选人：我是卫生学院理疗系的助理教授南卡罗来纳州查尔斯顿南卡罗来纳医科大学的职业。我的长期目标是成为一名资金充足的独立研究人员，调查阿尔茨海默氏症患者的急性后护理疾病及相关痴呆(ADRD)。为了实现这一目标，我将依靠我的临床专业知识和目前的研究培训。在K01期间，我设定了四个短期培训目标：(1)发展在影响ADRD患者的急性后护理政策方面的能力，(2)发展管理和 ADRD患者医疗保险数据的操纵，(3)运用倾向评分法培养能力对ADRD患者的数据进行数据分析，以及(4)提高我的勇气，道德行为研究，以及职业发展和晋升的指导技能。指导团队：我的主要导师是Kit Simpson博士，我的共同导师是Kenneth Ottenbacher博士， Otr。指导团队的其他成员包括Annie Simpson博士、Jacobo Mintzer、MD、MBA和凯瑟琳·H·鲍尔斯博士，RN，FAAN，FACMI。我的指导团队资历很高，包括全国和国际公认的卫生服务研究专家(K.Simpson)，急性后护理质量衡量 (K.Ottenbacher)，ADRD(J.Mintzer)，观察性研究的研究设计和分析方法(A. 和家庭健康实践、政策和研究(K.鲍尔斯)。我的指导团队将指导我的职业生涯开展开发活动，参与K01研究。研究策略：新冠肺炎推动2020年医保家庭健康发生前所未有的变化大流行和一种新的支付模式。这些巨大的变化可能会加剧现有的回家障碍为ADRD患者提供医疗服务。获得家庭健康的机会减少对ADRD患者造成伤害并可能引发对卫生保健系统的一系列资源和财务影响。《纽约时报》对目前ADRD患者的家庭保健机会和质量危机尚未得到审查，但已迫在眉睫需要的。此K01项目将使用匹配良好的组，以展示报销更改和通过分析大流行对患有和不患有ADRD的人获得家庭卫生服务的影响和结果联邦医疗保险评估和账单数据。将使用倾向评分法来平衡患者的风险因素用于比较组。目标1：描述在获得家庭卫生服务方面的差异，以及 2019年，有无ADRD的医疗保险受益人(MBS)群体进行了匹配。目标2：检查中的更改 2019年与2020年匹配良好的MBS群体的家庭健康获取和结果。目标3：检查更改在2019年与2021年匹配的MBS群体的家庭健康获取和结果方面。由此得出的结论研究有助于优化ADRD患者和医疗保险系统患者的获取途径、成本和结果为宣传工作、当前的家庭健康实践和未来的急性后护理政策提供信息。