Aging in Community Health Clinics: Multimorbidity Patterns among Middle-Aged and Older Adults (ACHES)

社区卫生诊所的老龄化：中年和老年人的多重发病模式 (ACHES)

• 批准号: 9814317
• 负责人: Ana Roman Quinones
• 金额: $ 56.69万
• 依托单位: OREGON HEALTH & SCIENCE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2019
• 资助国家: 美国
• 起止时间: 2019-09-01 至 2024-04-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9814317
• 关键词: Accident and Emergency department; Address; Adult; African American; Age; Aging; Area; Caring; Cessation of life; Chronic; Chronic Disease; Clinic; Clinical; Clinical Data; Communities; Community Health; Community Health Networks; Complex; Cost of Illness; Data; Databases; Decision Making; Diagnosis; Disease; Disease Progression; Elderly; Electronic Health Record; Ethnic Origin; Ethnic group; Exhibits; Future; Health; Health Insurance; Healthcare; Hospital Departments; Income; Individual; Inpatients; Insurance Coverage; Knowledge; Life Cycle Stages; Link; Longevity; Low income; Medicaid; Modeling; Neighborhood Health Center; Neighborhoods; Oregon; Outcome; Patients; Pattern; Policies; Population; Prevalence; Process; Psyche structure; Quality of Care; Race; Records; Research; Resources; Risk; Sampling; Specific qualifier value; Symptoms; Testing; Time; United States; Visit; Work; age related; aged; care seeking; clinical care; cost; data registry; deprivation; early onset; experience; health care service; health care service utilization; health data; insight; intervention program; middle age; mortality; mortality risk; multiple chronic conditions; neoplasm registry; patient oriented; peer; programs; racial and ethnic; racial diversity; safety net; segregation; sex; social; social health determinants; sociodemographics

Project Summary Multimorbidity among older adults is prevalent, disabling, and costly. Vulnerable adults may be at even greater risk of multimorbidity earlier in the lifespan and may also experience sequelae and additional diagnoses that increase multimorbidity burden over time. Greater understanding of how disease patterns change over time and putative interactions with individual and community-level factors motivates the current proposed project that centers on the health of vulnerable adults. This work will advance the field of multimorbidity and aging in important ways by addressing key gaps in knowledge: (1) What kinds of multimorbidity patterns are most common among patients seeking care in community health centers (CHCs) and how do these patterns change over time? (2) Do community-level factors moderate the association between multimorbidity and poor health outcomes for CHC patients? (3) Do middle-aged and older adults seeking care in CHC settings demonstrate more rapid age-related declines (e.g., greater burden of multimorbidity, complex patterns of multimorbidity) compared to their non-CHC health care seeking peers? And, (4) How do health care needs and utilization change for middle-aged and older adults with multimorbidity? Our proposed research leverages clinical electronic health record (EHR) data from large networks of CHCs and non-CHCs. We anticipate important insights from findings that will inform clinical processes (workflow, clinical care decision-making) and policies that serve safety-net populations by identifying multimorbidity patterns predictive of rapid health downturns. We propose three aims to: Aim 1. Identify the prevalence, patterns, and health outcomes associated with specific multimorbidity combinations for middle-aged and older CHC patients over time and by sociodemographic factors. Aim 2. Identify community-level social determinants of health that moderate the relationship between multimorbidity combinations and disease progression, exacerbations, and mortality among middle-aged and older CHC patients. Aim 3. Specify multimorbidity prevalence and patterns over time among middle-aged and older adults seeking care in CHC relative to matched counterparts seeking care in non-CHC settings.

项目总结