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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，现有的数据有限