Measuring and Mapping National Pediatric Acute Care Outcomes
Measuring and Mapping National Pediatric Acute Care Outcomes
批准号:
10714729
负责人:
Kenneth Michelson
金额:
$38.98万
依托单位国家:
美国
项目类别:
财政年份:
2023
资助国家:
美国
项目状态:
未结题
起止时间:
2023-09-22 至 2028-06-30
关键词:
Accident and Emergency departmentAdultAlgorithmic AnalysisAppendicitisAreaAtlasesCaringChildChild CareChildhoodCommunitiesComparative Effectiveness ResearchComplexContinuity of Patient CareCost AnalysisCritical IllnessCritically ill childrenDataData SetDatabasesDetectionDiagnosisDiseaseDistrict of ColumbiaEmergency CareEmergency MedicineEmergency SituationEmergency department visitEmergency medical serviceEnsureEpidemiologyExpenditureFamilyGeographic LocationsGeographyHealth Service AreaHealth ServicesHealthcareHospitalsHuman ResourcesIndividualIndividual AdjustmentInjuryInterdisciplinary StudyKnowledgeLeadLinkMapsMeasurementMeasuresMethodologyMethodsModelingNational Institute of Child Health and Human DevelopmentNervous System TraumaOperative Surgical ProceduresOutcomeOutcome MeasurePathway AnalysisPatient-Focused OutcomesPatientsPatternPatterns of CarePerformancePhysiciansPolicy MakerPopulationPositioning AttributePrivatizationProtocols documentationQuality of lifeReadinessReportingResearchResearch PersonnelResourcesRiskRisk AdjustmentRuralSepsisSeverity of illnessSmall-Area AnalysisStrategic PlanningStructureSystemTranslatingTraumaVariantWorkaccurate diagnosisacute carecare outcomescare seekingcare systemscostdata qualityexperiencehealth care service utilizationimprovedimproved outcomeinjuredinnovationlarge scale datalongitudinal databasemultilevel analysispediatric emergencypediatric patientspopulation healthpublic health priorities
中文摘要
项目摘要/摘要
在每年2,500万次急诊科(ED)就诊中,儿童由于以下原因经历了各种各样的护理
两个急救队在准备和能力方面的主要差异。这些差异关系到一种可能性,即
患者将得到准确的诊断和及时、高质量的治疗。衡量整个行业的结果
整个国家的儿科急救系统被证明是困难的,因为粒状的、国家的、地理编码的
医疗保健数据一直不可用;调查人员专注于个别疾病;区域医疗保健
地图已经过时;对个人风险进行风险调整的挑战比比皆是;而且因为每一个
疾病需要一种不同的方法来衡量其结果。使努力进一步复杂化的是复杂的
医院之间的关系网络,其中多个设施分担结果责任。这些
成人和儿童患者之间的关系有很大的不同,没有工作上的理解
国家儿科网络的结构。这项提案将克服这些挑战,创建
儿科急诊图集--对3770万例急诊结果的综合考察
全国的儿童,占美国儿童人口的一半。地图集将绘制区域地图
医院系统使用复杂的网络分析算法,称为社区检测。地图
这一结果将确定儿科护理的领域,在这些领域中有共同的护理责任。它将被用来
要确定儿童三种严重疾病的区域性结果:阑尾炎(最常见的
儿童的手术情况)、神经损伤(最常见的严重伤害原因)和败血症(a
出了名的难以诊断的疾病,这是最昂贵的疾病之一)。这一知识随后将提供
在此基础上比较区域系统,以阐明与高绩效相关的因素。我们还将使用
全美使用患者和付款人的实际支出来了解成本的最高质量方法
儿科地区。这项提议反映了尤尼斯·肯尼迪·施莱弗国家儿童研究所的优先事项
健康与人类发展:使用“大规模数据集来优化创伤、受伤、
以及“审查所有形式的危重疾病的流行病学和治疗”。
集中努力在全国范围内改善结果有可能改善人口健康,但
这取决于对结果的准确、多病种的理解。《地图集》将提供这样一个
理解,并将成为支持改善儿科急救工作的持久资源,
这将转化为国家儿童更好的生存和更高的生活质量。
英文摘要
PROJECT SUMMARY/ABSTRACT
Across 25 million emergency department (ED) visits annually, children experience widely variable care due to
major differences in readiness and capabilities between EDs. These differences bear on the likelihood that a
patient will receive an accurate diagnosis and timely, high-quality treatment. Measuring outcomes across the
entire national pediatric acute care system has proved difficult because granular, national, geocoded
healthcare data have been unavailable; investigators have focused on individual diseases; regional healthcare
maps are outdated; challenges abound with risk adjustment for individuals’ personal risk; and because each
disease requires a different approach to measure its outcomes. Further complicating efforts is the complex
network of relationships between hospitals in which multiple facilities share responsibility for outcomes. These
relationships are substantially different between adult and child patients, and there is no working understanding
of the structure of the national pediatric network. This proposal will overcome those challenges to create the
Atlas of Pediatric Acute Care, a comprehensive examination of the acute care outcomes of 37.7 million
children across the nation, which represents half of the US child population. The Atlas will map regional
hospital systems using sophisticated network analysis algorithms known as community detection. The map
that results will define regions of pediatric care in which there is a shared responsibility for care. It will be used
to determine regional outcomes across three serious conditions in children: appendicitis (the most common
surgical condition in children), neurotrauma (the most common cause of serious injury), and sepsis (a
notoriously difficult-to-diagnose condition that is one of the costliest). This knowledge will then provide the
basis to compare regional systems to elucidate the factors associated with high performance. We will also use
the highest-quality methods to understand costs, using actual patient and payer expenditures, across US
pediatric regions. This proposal reflects the priorities of the Eunice Kennedy Shriver National Institute of Child
Health and Human Development: to use “large-scale datasets to optimize outcomes for traumatized, injured,
and critically ill children” and to “examine the epidemiology and treatment of all forms of critical illness.”
Focusing efforts to improve outcomes nationally has the potential to improve the population health, but
depends on an accurate, multi-disease understanding of outcomes. The Atlas will provide such an
understanding and will emerge as an enduring resource to support efforts to improve pediatric acute care,
which will translate to better survival and higher quality of life for the nation’s children.
期刊论文(0)
专著(0)
科研奖励(0)
会议论文
Delayed Diagnosis of Serious Pediatric Emergency Conditions
-
批准号:10468713
-
项目类别:
-
资助金额:$11.32万
-
财政年份:2019
-
负责人:Kenneth Michelson
-
依托单位:
Delayed Diagnosis of Serious Pediatric Emergency Conditions
-
批准号:10246799
-
项目类别:
-
资助金额:$15.34万
-
财政年份:2019
-
负责人:Kenneth Michelson
-
依托单位:
Delayed Diagnosis of Serious Pediatric Emergency Conditions
-
批准号:10001484
-
项目类别:
-
资助金额:$15.36万
-
财政年份:2019
-
负责人:Kenneth Michelson
-
依托单位:
Delayed Diagnosis of Serious Pediatric Emergency Conditions
-
批准号:10866851
-
项目类别:
-
资助金额:$4.0万
-
财政年份:2019
-
负责人:Kenneth Michelson
-
依托单位:
海外基金