Development and Testing of Health Equity Measures in Home Health Care for Medicare Beneficiaries

医疗保险受益人家庭保健中健康公平措施的制定和测试

基本信息

项目摘要

PROJECT SUMMARY Home health care is an essential healthcare service and benefit under the Medicare insurance programs, aimed to improve health outcomes, reduce avoidable hospitalizations, and decrease institutional placements. Racial and ethnic minority Medicare beneficiaries utilize home health care at higher-rates compared to the general Medicare population. Despite the growth and increased use of home health in recent years, there is little evidence about the role of home health agency organizational structures in home health quality and equity. There is also a gap in knowledge about minority-serving home health agencies. Most “high-minority” agencies are rated as lower quality by CMS; however, they may also provide culturally and linguistically appropriate care that should be associated with the best outcomes and highest quality of care. This paradox will be explored using a strengths-based approach, to understand factors associated with high-quality home health care outcomes for racial- and ethnic minority patients overall, and within the context of minority-serving home health agencies. The overall objective of the proposed project is to create home health process and outcome equity measures by calculating race- and ethnicity-specific quality ratings to examine the organizational characteristics of home health agencies with the highest ratings and those with the highest share of patients of color. The evidence generated from this project will be an important first step in (1) creating better measures of health equity that center marginalized populations, and (2) designing and evaluating health systems and policy interventions with the goal of eliminating inequities in essential home health services. Informed by Donabedian’s Structure-Process-Outcomes framework, race- and ethnicity-specific home health quality ratings will be calculated for the process of care and outcome measures used in the Centers for Medicare and Medicaid Services (CMS) star ratings. This study will match, merge, and link national Medicare beneficiaries’ administrative, home health care assessment, and inpatient claims data with home health agency level CMS Care Compare data to evaluate within-home health agency racial inequities in care quality outcomes through two aims: (1) Compose and demonstrate the utility of race and ethnic group-specific home health agency quality ratings, adapting the methodology used by CMS Care Compare. We will evaluate utility of the new race- and ethnicity-specific measures in comparison to the original, overall measures through the calculation of reliability and informativeness metrics. (2) Assess home health agency structure as a predictor of quality and equity in home health agency process and outcomes. Home health agency structural factors (e.g., minority-serving, size, tenure, ownership, rurality) will be used to predict race- and ethnicity-specific care quality process (i.e., timely initiation of care) and outcome measures (e.g., functional improvements, hospitalizations). This work is both timely and significant, with the potential to profoundly impact quality and health equity measurement within home health and other healthcare sectors.
项目总结 家庭健康护理是医疗保险计划下的一项基本医疗服务和福利, 旨在改善健康结果,减少可避免的住院,并减少机构安置。 种族和少数民族医疗保险受益人利用家庭医疗保健的比率高于 普通医疗保险人口。尽管近年来家庭健康的增长和使用增加,但仍有 几乎没有证据表明家庭健康机构的组织结构在家庭健康质量和 公平。对为少数族裔服务的家庭健康机构的了解也存在差距。大多数“少数族裔” 中介机构被CMS评为质量较低的机构;然而,它们也可能在文化和语言上提供 适当的护理应该与最好的结果和最高质量的护理相关。这一悖论 将使用基于优势的方法进行探索,以了解与高品质家居相关的因素 在为少数族裔服务的背景下,为少数族裔和少数族裔患者提供全面的卫生保健结果 家庭健康机构。拟议项目的总体目标是创建家庭健康流程和 通过计算种族和民族特定的质量评级来衡量结果公平,以检查 最高评级和最高评级的家庭健康机构的组织特征 分享患者的颜色。这个项目产生的证据将是(1)创建 以边缘化人群为中心的更好的健康公平措施,以及(2)设计和评估健康 旨在消除基本家庭保健服务中的不平等现象的制度和政策干预。 由多纳贝迪安的结构-过程-结果框架、种族和族裔特定的家庭健康提供信息 将计算中心使用的护理过程和结果衡量的质量评级 医疗保险和医疗补助服务(CMS)星级评级。这项研究将匹配、合并和连接全国医疗保险 受益人的行政管理、家庭保健评估和住院索赔数据与家庭健康 机构级CMS护理比较数据以评估家庭卫生机构在护理质量方面的种族不平等 通过两个目标取得的成果:(1)编写和展示种族和族裔群体特定家园的效用 卫生机构质量评级,采用CMS Care Compare使用的方法。我们将评估效用 新的针对种族和族裔的措施与原来的总体措施相比,通过 可靠性和信息性指标的计算。(2)评估家庭健康机构结构作为预测 家庭健康机构过程和结果的质量和公平性。家庭健康机构的结构性因素(例如, 少数群体服务、规模、保有权、所有权、乡村)将用于预测特定于种族和民族的护理 质量过程(即及时开始护理)和结果措施(例如,功能改进, 住院)。这项工作既及时又意义重大,有可能深刻影响质量和 家庭健康和其他医疗保健部门的健康公平衡量。

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 }}

Shekinah Antoinette Fashaw-Walters其他文献

Shekinah Antoinette Fashaw-Walters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('Shekinah Antoinette Fashaw-Walters', 18)}}的其他基金

Disparities in Access to High-Quality Home Health and the Impact of Public Reporting
获得高质量家庭健康的差异以及公共报告的影响
  • 批准号:
    10041137
  • 财政年份:
    2020
  • 资助金额:
    $ 44.21万
  • 项目类别:

相似海外基金

BLACK RACE, BODY COMPOSITION, AND OSTEOPOROSIS
黑人种族、身体成分和骨质疏松症
  • 批准号:
    3876348
  • 财政年份:
  • 资助金额:
    $ 44.21万
  • 项目类别:
BLACK RACE, BODY COMPOSITION, AND OSTEOPOROSIS
黑人种族、身体成分和骨质疏松症
  • 批准号:
    3754507
  • 财政年份:
  • 资助金额:
    $ 44.21万
  • 项目类别:
BLACK RACE, BODY COMPOSITION, AND OSTEOPOROSIS
黑人种族、身体成分和骨质疏松症
  • 批准号:
    3840250
  • 财政年份:
  • 资助金额:
    $ 44.21万
  • 项目类别:
BLACK RACE, BODY COMPOSITION, AND OSTEOPOROSIS
黑人种族、身体成分和骨质疏松症
  • 批准号:
    3855270
  • 财政年份:
  • 资助金额:
    $ 44.21万
  • 项目类别:
BLACK RACE, BODY COMPOSITION, AND OSTEOPOROSIS
黑人种族、身体成分和骨质疏松症
  • 批准号:
    3776663
  • 财政年份:
  • 资助金额:
    $ 44.21万
  • 项目类别:
{{ showInfoDetail.title }}

作者:{{ showInfoDetail.author }}

知道了