Effect of Hospital and Community Care Coordination on Health Care Access, Quality and Equity among Individuals with Risk Factors or Diagnosis of ADRD
医院和社区护理协调对有 ADRD 危险因素或诊断的个人的医疗保健获取、质量和公平性的影响
基本信息
- 批准号:9789164
- 负责人:
- 金额:$ 34.61万
- 依托单位:
- 依托单位国家:美国
- 项目类别:
- 财政年份:2018
- 资助国家:美国
- 起止时间:2018-09-30 至 2021-02-28
- 项目状态:已结题
- 来源:
- 关键词:AddressAdultAffectAfrican AmericanAgeAgingAlzheimer&aposs DiseaseAlzheimer&aposs disease related dementiaAlzheimer&aposs disease riskAreaCaringCholesterolChronic CareChronic DiseaseCognitiveCommunitiesCommunity HospitalsContinuity of Patient CareCritical CareDataData SetDatabasesDementiaDiabetes MellitusDiagnosisDiseaseDisease ProgressionElderlyEnsureFaceGoalsHealthHealth PromotionHealth systemHealthcareHealthcare SystemsHispanicsHomelessnessHospitalsHousingHypertensionImprove AccessIndividualInformation SystemsInvestmentsLatinoLife StyleLinkLiteratureLongitudinal StudiesMedicareMedicare claimMinorityMissionObesityOrganizational ModelsOutcomePatientsPolicy MakerPopulationPrimary Health CarePublic HealthQuality of CareResearchResourcesRisk FactorsSavingsServicesSmokingSocial EnvironmentSurveysSystemTimeU.S. Department of Housing and Urban DevelopmentUnderserved PopulationVariantbasebeneficiarycare coordinationcostcost effectivedata sharingdementia caredementia riskdisorder controleconomic incentiveeffective care managementethnic minority populationexperiencefinancial incentivehealth care availabilityhealth care qualityhealth disparityimprovedinnovationinterestmild cognitive impairmentmodifiable riskmultidisciplinaryneglectorganizational structurepersonalized carepersonalized health carepopulation healthpreferenceprogramsracial and ethnic disparitiesracial minoritysocioeconomics
项目摘要
SUMMARY
Disparity populations, in particular aging African-Americans and Hispanics (65 years and older), are
significantly more likely to have Alzheimer’s disease and related dementia (ADRD) than older Whites in the
same age range. Delays in accessing timely primary care, lack of care coordination, and variations in lifestyle
and socioeconomic conditions are considered as major factors that contribute to racial and ethnic disparities.
Health care coordination, such as chronic care management and post-hospital discharge continuity of care
programs, has been identified as a critical component in improving quality of care and patient experience. In
addition, Accountable Care Organizations (ACOs) have been proposed to promote care coordination through
team-based approaches and financial incentives. However, little is known about how these system-level care
coordination strategies have improved health care access, quality and equity for populations with ADRD. The
objective of our project is to determine best hospital-community care coordination practices that can improve
effective management of ADRD and co-existing conditions; control/reduce modifiable risk factors of ADRD and
administer health care for these diseases in early stages; and eventually promote population health and reduce
health disparities. Our primary hypothesis is that integrating hospital and community care can improve quality
and equity among people with ADRD as well as cognitively healthy older adults at increased risk for ADRD.
We will leverage our comprehensive, national data on care coordination, and construct a multi-level data set
(individual-, hospital/ACO-, community-, and state- level) by linking Medicare claims data and Shared Savings
Program Accountable Care Organizations data to address our primary hypothesis. Using a population-level
longitudinal study (2012-2018), we aim to identify the influences of care coordination practices and ACOs on
health care access, quality, and cost for people with ADRD and older adults at increased risk for ADRD
(including adults living with diabetes, hypertension, high cholesterol, obesity, smoking, and mild cognitive
impairment) (Aims 1 and 2); estimate the impact of care coordination on one of the hardest-to-reach
populations: racial and ethnic minority populations who received federal housing assistance (who may have
experienced periods of homelessness) (Aim 3); and highlight care coordination practices and the ACO models
that can reduce racial and ethnic disparities (Aim 4). Our multidisciplinary, systems-based approach will enable
us to identify the most critical care coordination practices that will have the greatest impact on increasing
effective care for minority patients with ADRD; and control diseases in early stages among those with ADRD
risk factors. Our results will provide policy makers with critical information on how to utilize existing resources
to integrate care coordination across the health care system to ensure that minorities get access to the most
appropriate and effective care. The goal aligns with the National Plan to Address Alzheimer's Disease that
aims to enhance care quality and efficiency.
摘要
不平等人口,特别是老龄化的非洲裔美国人和西班牙裔美国人(65岁及以上)
在美国,患阿尔茨海默病和相关痴呆症(ADRD)的可能性明显高于年长的白人
同样的年龄范围。获得及时初级保健的延迟、缺乏护理协调以及生活方式的变化
社会经济条件被认为是造成种族和族裔差异的主要因素。
保健协调,例如慢性护理管理和出院后护理的连续性
计划,已被确定为改善护理质量和患者体验的关键组成部分。在……里面
此外,已提议责任护理组织(ACO)通过以下方式促进护理协调
以团队为基础的方法和财务激励。然而,人们对这些系统级护理是如何进行的知之甚少
协调战略改善了ADRD患者获得医疗保健的机会、质量和公平。这个
我们项目的目标是确定最佳的医院-社区护理协调做法,以改善
有效管理ADRD和共存情况;控制/减少ADRD和
在早期阶段对这些疾病进行卫生保健;并最终促进人口健康和减少
健康差距。我们的主要假设是,整合医院和社区护理可以提高质量
ADRD患者和认知健康的老年人之间的公平性,ADRD风险增加。
我们将利用我们全面的、全国性的护理协调数据,并构建一个多层次的数据集
(个人、医院/ACO、社区和州级别),将Medicare报销数据和共享储蓄联系起来
计划责任关怀组织数据,以解决我们的主要假设。使用人口级别
纵向研究(2012-2018),我们的目标是确定护理协调做法和ACOs对
ADRD患者和ADRD风险较高的老年人的医疗服务可获得性、质量和成本
(包括患有糖尿病、高血压、高胆固醇、肥胖、吸烟和轻度认知障碍的成年人
损害)(目标1和2);估计护理协调对最难触及的对象之一的影响
人口:接受联邦住房援助的种族和少数民族人口(可能有
(目标3);并强调护理协调做法和非政府组织模式
这可以减少种族和民族差异(目标4)。我们的多学科、基于系统的方法将使
美国将确定最关键的护理协调做法,这些做法将对增加
对少数民族ADRD患者进行有效护理;对ADRD患者进行早期疾病控制
风险因素。我们的结果将为决策者提供如何利用现有资源的关键信息
整合整个卫生保健系统的护理协调,以确保少数群体能够获得最多的
适当和有效的护理。这一目标与应对阿尔茨海默氏症的国家计划一致
旨在提高护理质量和效率。
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)
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{{ truncateString('Jie Chen', 18)}}的其他基金
The impact of hospital-based health information technology on health care quality and equity among patients with ADRD
基于医院的卫生信息技术对 ADRD 患者医疗保健质量和公平性的影响
- 批准号:
10729695 - 财政年份:2023
- 资助金额:
$ 34.61万 - 项目类别:
Effect of Hospital and Community Care Coordination on Health Care Quality and Equity among Individuals with Risk Factors or Diagnosis of ADRD
医院和社区护理协调对有 ADRD 危险因素或诊断的个体的医疗保健质量和公平性的影响
- 批准号:
10589023 - 财政年份:2021
- 资助金额:
$ 34.61万 - 项目类别:
Effect of Hospital and Community Care Coordination on Health Care Quality and Equity among Individuals with Risk Factors or Diagnosis of ADRD
医院和社区护理协调对有 ADRD 危险因素或诊断的个体的医疗保健质量和公平性的影响
- 批准号:
10353407 - 财政年份:2021
- 资助金额:
$ 34.61万 - 项目类别:
Effects of Hospital-Community-Public Health Integration on Racial and Ethnic Disparities in Mental Health
医院-社区-公共卫生一体化对心理健康中种族和民族差异的影响
- 批准号:
9924656 - 财政年份:2017
- 资助金额:
$ 34.61万 - 项目类别:
Effects of Hospital-Community-Public Health Integration on Racial and Ethnic Disparities in Mental Health
医院-社区-公共卫生一体化对心理健康中种族和民族差异的影响
- 批准号:
10021780 - 财政年份:2017
- 资助金额:
$ 34.61万 - 项目类别:
Effects of Hospital-Community-Public Health Integration on Racial and Ethnic Disparities in Mental Health
医院-社区-公共卫生一体化对心理健康中种族和民族差异的影响
- 批准号:
9329801 - 财政年份:2017
- 资助金额:
$ 34.61万 - 项目类别:
Effect of Local Health Departments on Health Care Disparities for Individuals with Mental Health Disorders
当地卫生部门对精神健康障碍患者医疗保健差异的影响
- 批准号:
9199107 - 财政年份:2016
- 资助金额:
$ 34.61万 - 项目类别:
Effect of Local Health Departments on Health Care Disparities for Individuals with Mental Health Disorders
当地卫生部门对精神健康障碍患者医疗保健差异的影响
- 批准号:
9034884 - 财政年份:2016
- 资助金额:
$ 34.61万 - 项目类别:
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