Quality of Epilepsy Treatment and Costs in Older Americans by Race (QUIET CARE)

按种族划分的美国老年人癫痫治疗质量和费用(安静护理)

基本信息

  • 批准号:
    8420004
  • 负责人:
  • 金额:
    $ 42.8万
  • 依托单位:
  • 依托单位国家:
    美国
  • 项目类别:
  • 财政年份:
    2012
  • 资助国家:
    美国
  • 起止时间:
    2012-09-30 至 2015-08-31
  • 项目状态:
    已结题

项目摘要

DESCRIPTION (provided by applicant): As of today, we have limited knowledge on the extent to which older Americans with epilepsy, especially typically disadvantaged minorities, receive antiepileptic drug treatment (AED) and follow-up care that is safe and effective. Epilepsy incidence peaks in older age as well as in childhood, and is higher in some minorities; e.g., it is 80% higher in African American (AA) compared to white Medicare beneficiaries. Appropriate treatment is crucial to optimize the chances of seizure control. Based on adult treatment effectiveness and safety data, the Quality Indicators for Epilepsy Treatment (QUIET) were developed in 2007 to assess quality of care. Previous literature suggests not all racial groups receive QUIET concordant care. In addition, poor AED adherence, also typically more common among minorities, limits seizure control. Improving care and adherence to AED treatment in all older adults with epilepsy has the potential to prevent avoidable seizures and also reduce medical costs. Our long-term goal is to inform and design interventions that improve the health care for older minorities with epilepsy and reduce health care costs associated with preventable events. The objective of this application is to examine the current quality of, and adherence to, AEDs and the current quality of care after recurrent seizures across racial groups of older Americans, and to identify opportunities for quality of care improvements and health care costs reductions as a first step toward the long term goal. The rationale for this research is that it is fundamental to inform the progression toward the national objective of living well with epilepsy and potentially reduce health care costs for the hundreds of thousands Medicare beneficiaries who suffer from this disorder. We plan to accomplish our objective by using Medicare administrative claims and a validated algorithm to identify epilepsy cases from these data, to pursue the following specific aims: 1) Assess quality of AED treatment across racial groups of Medicare beneficiaries with epilepsy. Our hypothesis is that, compared to white beneficiaries, typically disadvantaged minorities (e.g., AAs, Native Americans, Hispanics) are less likely to have QUIET concordant AED treatment and less likely to adhere to AEDs; 2) Determine the quality of care after seizure recurrence across race. We hypothesize that minority beneficiaries are less likely to have QUIET concordant care after recurrent seizures. Using the Behavioral Model of Access to Care, analyses for aims 1 and 2 will determine the contribution to racial disparities of, among others, current features of drug plans and geographic variation in care; and 3) determine if lower health care costs are associated with QUIET concordant care across racial groups. If H1-H3 are correct, we hypothesize that minority beneficiaries will be more likely to have high potentially preventable health care costs. This novel project will have a positive impact because it will provide much needed information to move the field toward improving epilepsy care, reducing disparities and potentially reducing costs for older adults. PUBLIC HEALTH RELEVANCE: The proposed research is relevant to public health because understanding whether older adults across minority groups are receiving the care that maximizes the chances of seizure control and good quality of life is expected to inform interventions for providers and/or patients that will ultimately lead to living well with epilepsy, reduce disparities as well as reduce health care costs. Thus, the proposed research is relevant to the National Institute of Neurological Disorders (NINDS)'s objective of assuring a life with "no seizure, no side effects" for all Americans with epilepsy. This is especially important as the US healthcare system deals with an ever increasing number of older adults with epilepsy.
描述(由申请人提供):截至今天,我们对患有癫痫的老年美国人,特别是通常处于不利地位的少数民族,接受抗癫痫药物治疗(AED)和安全有效的后续护理的程度了解有限。癫痫的发病率在老年和儿童时期达到高峰,在某些少数民族中更高;例如,是 非裔美国人(AA)比白色医疗保险受益人高80%。适当的治疗对于优化癫痫控制的机会至关重要。根据成人治疗有效性和安全性数据,2007年制定了癫痫治疗质量指标(QUIET),以评估护理质量。以前的文献表明,并非所有种族群体都能得到安静和谐的护理。此外,AED依从性差,在少数民族中也更常见,限制了癫痫控制。改善所有老年癫痫患者的护理和对AED治疗的依从性,有可能预防可避免的癫痫发作,并降低医疗成本。我们的长期目标是提供信息和设计干预措施,改善老年少数民族癫痫患者的医疗保健,并降低与可预防事件相关的医疗保健成本。本申请的目的是检查目前的质量,坚持,抗癫痫药物和目前的护理质量后,反复发作的种族群体的美国老年人,并确定机会的护理质量的改善和医疗保健成本的降低作为第一步的长期目标。这项研究的基本原理是, 这对于向癫痫患者生活良好的国家目标迈进至关重要,并可能减少数十万患有这种疾病的医疗保险受益人的医疗保健费用。我们计划通过使用医疗保险行政索赔和经过验证的算法来实现我们的目标,以从这些数据中识别癫痫病例,以实现以下具体目标:1)评估AED治疗的质量,包括癫痫医疗保险受益人的种族群体。我们的假设是,与白色受益人相比,通常处于不利地位的少数群体(例如,AAs、美洲原住民、西班牙裔)不太可能接受安静一致的AED治疗,也不太可能坚持使用AED; 2)确定不同种族癫痫复发后的护理质量。我们假设,少数受益人不太可能有安静的和谐护理后,反复发作。使用获得护理的行为模型,对目标1和2的分析将确定对种族差异的贡献,其中包括药物计划的当前特征和护理的地理差异;以及3)确定较低的医疗保健费用是否与跨种族群体的安静一致的护理相关。如果H1-H3是正确的,我们假设少数受益人将更有可能 有很高的潜在可预防的医疗费用。这个新的项目将产生积极的影响,因为它将提供急需的信息,以推动该领域朝着改善癫痫护理,减少差距和潜在的降低老年人的成本。 公共卫生相关性:拟议的研究与公共卫生有关,因为了解少数群体中的老年人是否正在接受最大限度地提高癫痫控制和良好生活质量的机会的护理,预计将为提供者和/或患者提供干预措施,最终导致癫痫患者生活良好。 减少差距,降低医疗成本。因此,拟议的研究与国家神经疾病研究所(NINDS)的目标有关,即确保生活中“没有”。 癫痫发作,无副作用”的所有美国癫痫患者。这一点尤其重要,因为美国医疗保健系统正在处理越来越多的老年癫痫患者。

项目成果

期刊论文数量(0)
专著数量(0)
科研奖励数量(0)
会议论文数量(0)
专利数量(0)

数据更新时间:{{ journalArticles.updateTime }}

{{ item.title }}
{{ item.translation_title }}
  • DOI:
    {{ item.doi }}
  • 发表时间:
    {{ item.publish_year }}
  • 期刊:
  • 影响因子:
    {{ item.factor }}
  • 作者:
    {{ item.authors }}
  • 通讯作者:
    {{ item.author }}

数据更新时间:{{ journalArticles.updateTime }}

{{ item.title }}
  • 作者:
    {{ item.author }}

数据更新时间:{{ monograph.updateTime }}

{{ item.title }}
  • 作者:
    {{ item.author }}

数据更新时间:{{ sciAawards.updateTime }}

{{ item.title }}
  • 作者:
    {{ item.author }}

数据更新时间:{{ conferencePapers.updateTime }}

{{ item.title }}
  • 作者:
    {{ item.author }}

数据更新时间:{{ patent.updateTime }}

MARIA PISU其他文献

MARIA PISU的其他文献

{{ item.title }}
{{ item.translation_title }}
  • DOI:
    {{ item.doi }}
  • 发表时间:
    {{ item.publish_year }}
  • 期刊:
  • 影响因子:
    {{ item.factor }}
  • 作者:
    {{ item.authors }}
  • 通讯作者:
    {{ item.author }}

{{ truncateString('MARIA PISU', 18)}}的其他基金

Administrative Core-001
行政核心-001
  • 批准号:
    10660381
  • 财政年份:
    2023
  • 资助金额:
    $ 42.8万
  • 项目类别:
Development Core-003
开发核心-003
  • 批准号:
    10660386
  • 财政年份:
    2023
  • 资助金额:
    $ 42.8万
  • 项目类别:
Core 3: Assessment and Analysis Shared Resource Core
核心3:评估与分析共享资源核心
  • 批准号:
    10247790
  • 财政年份:
    2018
  • 资助金额:
    $ 42.8万
  • 项目类别:
Core 2: Recruitment and Retention Shared Resource Core
核心 2:招聘和保留共享资源核心
  • 批准号:
    10247788
  • 财政年份:
    2018
  • 资助金额:
    $ 42.8万
  • 项目类别:
Quality of Epilepsy Treatment and Costs in Older Americans by Race (QUIET CARE)
按种族划分的美国老年人癫痫治疗质量和费用(安静护理)
  • 批准号:
    8554328
  • 财政年份:
    2012
  • 资助金额:
    $ 42.8万
  • 项目类别:
PILOT PROJECT 4
试点项目 4
  • 批准号:
    7129229
  • 财政年份:
    2005
  • 资助金额:
    $ 42.8万
  • 项目类别:

相似海外基金

Structural Racism, Pharmacy Closures and Disparities in Medication Adherence Among Older Adult Medicare Part-D Beneficiaries
结构性种族主义、药房关闭以及老年人医疗保险 D 部分受益人的药物依从性差异
  • 批准号:
    10568717
  • 财政年份:
    2023
  • 资助金额:
    $ 42.8万
  • 项目类别:
Medication Adherence and Cardio-Metabolic Control Indicators among Adult American Indians Receiving Tribal Health Services
接受部落卫生服务的成年美洲印第安人的药物依从性和心脏代谢控制指标
  • 批准号:
    10419967
  • 财政年份:
    2022
  • 资助金额:
    $ 42.8万
  • 项目类别:
Medication Adherence and Cardio-Metabolic Control Indicators among Adult American Indians Receiving Tribal Health Services
接受部落卫生服务的成年美洲印第安人的药物依从性和心脏代谢控制指标
  • 批准号:
    10592441
  • 财政年份:
    2022
  • 资助金额:
    $ 42.8万
  • 项目类别:
Leveraging Technology to Improve Medication Adherence in Adolescent and Young Adult Kidney or Liver Transplant Recipients
利用技术提高青少年和年轻肾移植或肝移植受者的药物依从性
  • 批准号:
    10369750
  • 财政年份:
    2021
  • 资助金额:
    $ 42.8万
  • 项目类别:
Leveraging Technology to Improve Medication Adherence in Adolescent and Young Adult Kidney or Liver Transplant Recipients
利用技术提高青少年和年轻肾移植或肝移植受者的药物依从性
  • 批准号:
    10633248
  • 财政年份:
    2021
  • 资助金额:
    $ 42.8万
  • 项目类别:
Leveraging Technology to Improve Medication Adherence in Adolescent and Young Adult Kidney or Liver Transplant Recipients
利用技术提高青少年和年轻肾移植或肝移植受者的药物依从性
  • 批准号:
    10487516
  • 财政年份:
    2021
  • 资助金额:
    $ 42.8万
  • 项目类别:
Mhealth for Pre-exposure Prophylaxis Adherence by Young Adult MSM
Mhealth 促进年轻 MSM 遵守暴露前预防
  • 批准号:
    10228564
  • 财政年份:
    2018
  • 资助金额:
    $ 42.8万
  • 项目类别:
Mhealth for Pre-exposure Prophylaxis Adherence by Young Adult MSM
Mhealth 促进年轻 MSM 遵守暴露前预防
  • 批准号:
    9347041
  • 财政年份:
    2017
  • 资助金额:
    $ 42.8万
  • 项目类别:
Mindfulness training with HIV-positive youth and adult family members to improve treatment adherence
对艾滋病毒呈阳性的青少年和成年家庭成员进行正念训练,以提高治疗依从性
  • 批准号:
    9480702
  • 财政年份:
    2016
  • 资助金额:
    $ 42.8万
  • 项目类别:
Mindfulness training with HIV-positive youth and adult family members to improve treatment adherence
对艾滋病毒呈阳性的青少年和成年家庭成员进行正念训练,以提高治疗依从性
  • 批准号:
    9906853
  • 财政年份:
    2016
  • 资助金额:
    $ 42.8万
  • 项目类别:
{{ showInfoDetail.title }}

作者:{{ showInfoDetail.author }}

知道了