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Quantifying the Burden of Disease and Healthcare Need in Veterans and Civilians

量化退伍军人和平民的疾病负担和医疗保健需求

基本信息

批准号：
10845255
负责人：
Katherine JoAnn Hoggatt
金额：
--
依托单位：
VA GREATER LOS ANGELES HEALTHCARE SYSTEM
依托单位国家：
美国
项目类别：
财政年份：
2020
资助国家：
美国
起止时间：
2020-10-01 至 2023-03-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/10845255
关键词：
20 year old Acceleration Achievement Affordable Care Act Age Behavioral Risk Factor Surveillance System Caring Clinic Communities Community Health Community Healthcare Comprehensive Health Care Consensus Data Drug usage Elderly man Ensure Ethnic Origin Evaluation Foundations Funding Gender General Population Geographic Locations Goals Health Health Services Accessibility Health Status Health behavior Healthcare Healthcare Systems Impairment Injury Integrated Health Care Systems Knowledge Learning Marketing Measures Medical Medicare Mental Health Methodology Methods Modernization National Health Interview Survey Outcome Outcome Study Outpatients Patients Pattern Policies Policy Maker Population Population Characteristics Population Distributions Prevalence Preventive care Private Sector Privatization Probability Process Provider Public Sector Race Readiness Reporting Research Resources Risk Risk Factors Services Source Subgroup Surveys System Time Update Veterans Veterans Health Administration Vision Visual War Work burden of illness care outcomes comorbidity comparative data warehouse demographics design evidence based guidelines health care availability health care service health care service utilization health difference health equity health plan health related quality of life improved innovation integrated care neglect physical conditioning programs provider networks routine practice secondary analysis sociodemographics

项目摘要

Background: With rapid acceleration of Veterans’ use of care in the community, limited data exist to prepare community providers and others in the broader VA integrated care network. Many community providers and health plans may assume Veteran patients are similar to their routine practice populations, composed primarily of civilians, although prior research would suggest otherwise. Significance/Impact: The proposed study will use detailed, current, and comprehensive data from the Behavioral Risk Factor Surveillance System (BRFSS), National Health Interview Survey (NHIS), the National Surveys on Drug Use and Health (NSDUH), and VA Corporate Data Warehouse (CDW) to quantify broadly the distribution of health and healthcare factors for Veterans, VA users, and VA non-users and to evaluate in-depth the factors that differ between Veterans and civilians. This information will not only substantially update our knowledge of how Veterans are similar to or different from civilians but will also be used by VA policymakers to improve the design and readiness of community care partners as VA referrals increase. Innovation: In contrast to previous studies and reports using national survey data, the proposed project will include VA data to provide a richer description of VA patients than is possible using only publicly-available data on VA users, and examine in depth the patterns in Veterans’ health and healthcare across subgroups and over time. The proposed research has no corollary or antecedent study in VA HSR&D’s or QUERI’s portfolio, and of the studies funded outside the VA that use one or more of these sources and is underway or recently completed, none proposed to use VA data or to combine the breadth and depth of the proposed project Specific Aims: This project aims to 1. Quantify the distribution of population characteristics, health behaviors, health conditions, health status, access to care, and healthcare utilization among Veterans overall and among VA users and non-users; 2. Evaluate the extent to which patterns in population-, health-, and healthcare- related factors differ between Veterans and civilians; 3. Determine whether the patterns identified under Aims 1 and 2 vary for subgroups defined by age, gender, and race-ethnicity; and, 4. Conduct an expert panel to review results from Aims 1-3 to come to consensus on evidence-based recommendations for improved community care (e.g., community provider readiness) and health equity. Methodology: We will conduct a secondary analysis using multiple years of data from BRFSS, NHIS, NSDUH, and VA CDW. Our analyses will include measures for Veteran and VA user status, geographic region, population characteristics, health behaviors and conditions, and healthcare outcomes, such as access, utilization, and unmet need for care. We will quantify the distribution of population-, health-, and healthcare- related factors among Veterans, VA users, and VA non-users, evaluate how these factors differ between Veterans and civilians, assess the extent to which VA use moderates differences between Veterans and civilians, and assess how patterns for Veterans differ across population subgroups. We will use modified Delphi panel methods to critically appraise findings, rate their importance, feasibility, and potential for Veteran impacts, and come to consensus on evidence-based recommendations for community care and health equity. Next Steps/Implementation: We will engage diverse stakeholders as advisors/panelists (e.g., national program office, VISN, VAMC and Veteran representatives) in design of dissemination products (e.g., fact sheets, visual abstracts) for different venues that meet end user needs in addition to traditional scientific products. Integrated into the panel process will be explicit planning for products capable of informing and supporting potential practice and policy changes and their subsequent implementation.

背景：随着退伍军人在社区中使用护理的快速加速，可供准备的数据有限社区提供者和更广泛的VA综合护理网络中的其他人。许多供应商和健康计划可能假设退伍军人患者与他们的常规实践人群相似，主要由平民，尽管先前的研究表明并非如此。重要性/影响：拟议的研究将使用来自行为风险因素监测系统（BRFSS）、国家健康访谈调查（NHIS）、国家药物使用和健康调查（NSDUH）和VA公司数据仓库（CDW），以广泛量化退伍军人、VA使用者和VA非使用者的健康和医疗保健因素分布，并深入评估退伍军人和平民之间的差异。这些信息不仅将大大更新我们的退伍军人如何与平民相似或不同的知识，但也将被退伍军人事务部政策制定者用来随着退伍军人事务部转诊的增加，改善社区护理合作伙伴的设计和准备。创新：与以往使用国家调查数据的研究和报告不同，拟议项目将包括VA数据，以提供比仅使用公开可用数据更丰富的VA患者的描述对退伍军人管理局用户，并深入研究模式，在退伍军人的健康和医疗保健跨亚组和以上时间拟议的研究在VA HSR&D或QUERI的投资组合中没有推论或先行研究，在退伍军人事务部以外资助的研究中，有哪些使用了一个或多个这些来源，并且正在进行或最近进行已完成，没有人提议使用VA数据或联合收割机结合拟议项目的广度和深度具体目标：本项目的目标是1。量化人口特征、健康行为、健康状况，健康状况，获得护理和医疗保健利用之间的退伍军人整体和用户和非用户; 2。评估人口、健康和医疗保健模式的程度，退伍军人和平民的相关因素不同; 3.确定目标1下确定的模式和2不同的亚组定义的年龄，性别和种族，种族;和，4。组织一个专家小组审查目标1-3的结果，就改善社区的循证建议达成共识护理（例如，社区提供者准备）和卫生公平。方法：我们将使用来自BRFSS、NHIS、 NSDUH和VA CDW。我们的分析将包括退伍军人和VA用户状态，地理位置，区域、人口特征、健康行为和状况以及医疗保健结果，如可及性，利用率和未满足的护理需求。我们将量化人口，健康和医疗保健的分布- 退伍军人，VA用户和VA非用户之间的相关因素，评估这些因素之间的差异退伍军人和平民，评估在何种程度上VA使用温和的差异退伍军人和平民，并评估退伍军人的模式如何在人口亚群中有所不同。我们将使用修改德尔菲小组方法，以批判性地评估结果，评价其重要性，可行性和潜力，为退伍军人影响，并就社区护理和健康公平的循证建议达成共识。后续步骤/实施：我们将邀请不同的利益相关者担任顾问/小组成员（例如，国家项目办公室、VISN、VAMC和退伍军人代表）设计传播产品（例如，事实表，视觉摘要），以满足终端用户的需求，除了传统的科学产品.纳入小组进程的将是明确规划能够提供信息的产品，支持可能的做法和政策变化及其随后的实施。