The Social-Medical Network: Using a Network Approach to Explore the Integration of Informal and Formal Care Networks of Older Adults

社会医疗网络：利用网络方法探索老年人非正式和正式护理网络的整合

• 批准号: 10724756
• 负责人: Catherine Ann Clair
• 金额: $ 6.06万
• 依托单位: JOHNS HOPKINS UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-08-01 至 2024-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10724756
• 关键词: Accident and Emergency department; Acute; Address; Adult; Adult Children; Age; Aging; Area; Caregivers; Caring; Characteristics; Chronic; Communities; Community Healthcare; Data; Disabled Persons; Disease; Elderly; Emotional; Equipment and supply inventories; Family; Family Caregiver; Fostering; Foundations; Friends; Future; Grouping; Health; Health Care Costs; Health Insurance; Health Personnel; Health Professional; Health Services; Healthcare; Healthcare Systems; Hospitalization; Human; Individual; Intervention; Literature; Managed Care; Measures; Medical; Medicare; Medicare claim; Mental Health; Methods; Mission; Modeling; Non-Insulin-Dependent Diabetes Mellitus; Older Population; Outcome; Pathway Analysis; Patients; Personal Satisfaction; Physicians; Policies; Population; Provider; Reporting; Research; Research Personnel; Resources; Scientist; Services; Social Network; Social Workers; Specialist; Spouses; Structure; Suggestion; United States; Visit; Work; aged; beneficiary; care recipients; demographics; density; direct application; health care service; health disparity; healthspan; healthy aging; improved; improved outcome; informal care; informal caregiver; informal support; innovation; insight; multiple chronic conditions; novel; physical therapist; prevent; primary care provider; service utilization; social; social structure; statistics; urgent care; wound care

PROJECT SUMMARY Due to factors such as multimorbidity and access to Medicare health insurance, older adults are often frequent users of the formal health care system. Their formal health providers may range from primary care providers to specialists (e.g., cardiologist) and direct care workers. The various formal health care providers of an older adult form a social network of care. Thus, the connections that exist between the older adult and their formal health care professionals act as a formal care network, centered on the older adult. In addition to formal health care providers, older adults may have informal caregivers, defined as family, friends, and neighbors who provide care to older adults or individuals with disability, illness, or other debilitating conditions. There is a lack of research about the number of informal caregivers, the type and amount of care and support provided, and the quality of the relationship between the patient and caregiver. There is also a gap in examining how informal caregivers of an older adult form a social network of care, or an informal care network centered on an older adult. Literature has suggested that these two networks (i.e., formal and informal) do not operate separately but instead are dynamically integrated. The interaction between the two networks forms a larger network: The social-medical network. The social-medical network represents the larger network comprised of the two subnetworks and their integration (density) across. To our knowledge, no studies have proposed nor been conducted on the social-medical network. There is also little understanding on how the informal and formal care networks operate together to improve health outcomes for older adults. Using social network methods and analysis, this study aims to measure the social-medical networks of older adults and explore its association with escalating acute service utilization (e.g., urgent care, emergency department, and unplanned hospitalization). This study will examine the social-medical network among a population of older adults with Type 2 diabetes. The specific aims of this study are (SA1) To characterize the structure, function, and quality of the informal care, formal care, and social-medical networks; (SA2) To compare escalating acute service utilization by the characteristics of the informal and formal care subnetworks; and (SA3) To examine the association between density of the social-medical network and escalated use of acute health services. This study will measure an unexplored network that may be associated with utilization outcomes of older adults, laying the foundation for improving the human healthspan, improving lives of informal caregivers, lowering health care costs, and strengthening care communities. This research also aligns with the NIA’s mission and research strategies to promote innovative work in areas and disease domains with established health disparities among older adults, such as Type 2 diabetes. Findings will contribute a new concept to the literature, a novel application of existing methods, and additional mechanisms that may influence the health outcomes of an older adult.

项目摘要 由于多次死亡和获得Medicare医疗保险等因素，老年人经常 正规医疗保健系统的使用者。他们的正式保健提供者可能包括初级保健提供者， 专家（例如，心脏病专家）和直接护理人员。老年人的各种正规医疗保健提供者 成年人形成一个关怀的社会网络。因此，存在于老年人和他们的正式之间的联系 卫生保健专业人员充当以老年人为中心的正式保健网络。除了正式的健康 照顾者，老年人可能有非正式的照顾者，定义为家庭，朋友和邻居， 为老年人或残疾、疾病或其他衰弱状况的个人提供护理。都缺乏 关于非正规护理人员的人数、所提供护理和支助的类型和数量的研究，以及 病人和看护者之间的关系质量。在研究非正式的 老年人的照顾者形成一个社会护理网络，或一个以老年人为中心的非正式护理网络。 成年人了文献表明，这两个网络（即，正式和非正式）不起作用 而是动态地集成。两个网络之间的互动形成了一个 更大的网络：社会医疗网络。社会医疗网络代表了更大的网络 由两个子网及其集成（密度）组成。据我们所知，没有研究 也没有在社会医疗网络上提出或进行。人们也不太了解 非正式和正式护理网络共同运作，以改善老年人的健康状况。使用 社会网络方法和分析，本研究旨在测量老年人的社会-医疗网络， 成人并探索其与不断升级的急性服务利用率的关联（例如，紧急护理， 急诊室和计划外住院）。这项研究将探讨社会医疗 2型糖尿病患者中的一个网络。本研究的具体目标是（SA 1） 描述非正式护理、正式护理和社会医疗网络的结构、功能和质量; (SA2)通过非正式和正式护理的特点比较急性服务利用率的上升 （SA 3）检查社会医疗网络的密度与 紧急医疗服务的使用量增加。这项研究将测量一个未开发的网络， 与老年人的利用成果，为提高人类健康水平奠定基础， 非正式护理人员的生活，降低医疗保健成本和加强护理社区。本研究 也与NIA的使命和研究战略保持一致，以促进在疾病领域的创新工作 在老年人中存在健康差异的领域，如2型糖尿病。发现将 为文献提供了一个新的概念，现有方法的新应用，以及额外的机制 这可能会影响老年人的健康状况。