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

项目总结 由于多发病和获得医疗保险的机会等因素，老年人经常出现 正规医疗保健系统的使用者。他们的正规医疗服务提供者可能从初级保健提供者到 专家(例如心脏病专家)和直接护理人员。老年人的各种正式医疗保健提供者 成年人形成了一个照顾的社会网络。因此，老年人和他们的正式成员之间存在的联系 卫生保健专业人员作为一个正式的护理网络，以老年人为中心。除了正式的健康 照顾者，老年人可能有非正式的照顾者，定义为家人、朋友和邻居 为老年人或有残疾、疾病或其他衰弱状况的个人提供护理。有一种缺乏 关于非正式照顾者的人数、提供的护理和支助的类型和数量的研究，以及 病人和照顾者之间的关系的质量。在考察非正式程度方面也存在差距。 老年人的照顾者形成了一个社会护理网络，或以老年人为中心的非正式护理网络 成年人。文献表明，这两个网络(即正式和非正式)并不起作用 它们是分开的，而是动态集成的。这两个网络之间的交互形成了 更大的网络：社会医疗网络。社会-医疗网络代表着更大的网络 由两个子网络及其集成(密度)组成。据我们所知，没有研究 还没有提出，也没有在社会医疗网络上进行。人们也很少了解如何 非正规和正规护理网络共同运作，以改善老年人的健康状况。vbl.使用 社会网络的方法和分析，本研究旨在测量老年人的社会医疗网络 并探讨其与急诊服务使用率不断上升的关联(例如，紧急护理， 急诊科和计划外住院)。这项研究将考察社会医学 在患有2型糖尿病的老年人群中建立网络。这项研究的具体目的是(SA1) 描述非正式护理、正规护理和社会-医疗网络的结构、功能和质量； (Sa2)比较非正规护理和正规护理的特点对急诊服务利用率不断上升的影响 子网络；以及(SA3)检查社会-医疗网络的密度和 对急性卫生服务的使用升级。这项研究将测量一个未知的网络，它可能与 利用老年人的成果，为改善人类健康寿命奠定基础，改善 改善非正式照顾者的生活，降低医疗保健成本，加强护理社区。这项研究 也与NIA的使命和研究战略保持一致，以促进在领域和疾病方面的创新工作 在老年人中存在健康差距的领域，如2型糖尿病。调查结果将 为文献提供新的概念，对现有方法和其他机制进行新的应用 这可能会影响老年人的健康结果。

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.