Disasters and Hospital Systems Serving Health Disparity Populations: Identifying the Long Term effects of the COVID-19 Pandemic to Mitigate Future Challenges

为健康差异人群提供服务的灾害和医院系统：确定 COVID-19 大流行的长期影响以缓解​​未来的挑战

• 批准号: 10584977
• 负责人: Eric Goralnick
• 金额: $ 72.64万
• 依托单位: BRIGHAM AND WOMEN'S HOSPITAL
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-07-15 至 2026-12-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10584977
• 关键词: Address; Administrator; Affect; American Hospital Association; COVID-19; COVID-19 pandemic; COVID-19 pandemic effects; Case Study; Characteristics; Communities; Complex; Consensus; Data Sources; Disasters; Emergency Situation; Engineering; Event; Face; Financial cost; Frequencies; Future; Goals; Health; Health Care Coalitions; Health Status; Health protection; Health system; Healthcare; Healthcare Systems; Hospitals; Intervention; Interview; Investigation; Link; Long-Term Effects; Longitudinal Studies; Medicaid; Medical; Medicine; Methods; Morbidity - disease rate; Nature; Outcome; Patients; Persons; Play; Policies; Population; Preparation; Public Health; Readiness; Recommendation; Recovery; Reduce health disparities; Resources; Role; Sampling; Services; Structure; Surveys; System; Time; Uninsured; United States National Academy of Sciences; Variant; Vulnerable Populations; Work; climate disaster; design; ethnic minority; experience; health disparity populations; improved; innovation; lens; long term consequences of COVID-19; man-made disasters; member; mortality; operation; outcome disparities; pandemic disease; patient population; policy recommendation; programs; promote resilience; racial minority; resilience; response; severe weather; social; societal costs; stressor; success; underserved community; virtual; weather-related disaster

Hospital Systems Serving Health Disparity Populations (HSSHDPs) deliver needed services to racial and ethnic minorities and other underserved communities. HSSHDPs may experience long-term effects of natural and man-made disasters that in turn could affect health outcomes for the populations they serve. The COVID- 19 pandemic has affected virtually every US healthcare system and, therefore, provides a unique opportunity to study the effects of large-scale and long-term stressors on under-resourced systems serving vulnerable patient populations. Using the framework of the disaster management cycle (mitigation, preparedness, response, and recovery), this project proposes to conduct a mixed methods study of the long-term effects of COVID-19 on US hospitals across four critical domains (quality, workforce, finances, and innovation), with a special focus on HSSHDPs and on the health disparity populations they serve. This project will be the first major national investigation of the effects of a national disaster on HSSHDPs. This rigorous mixed methods study will be significant in identifying HSSDHPS most and least affected by the COVID-19 pandemic and will deepen the understanding of the contributing factors that led to successes and challenges. The study will identify actionable best practices and challenges to HSSHDPs' operations before, during and after the COVID-19 pandemic. The specific aims of this study are: Aim 1. Describe the long-term effects of COVID-19 on hospitals and the perceived usefulness of disaster management planning activities (including interactions with Coalitions). In partnership with the American Hospital Association and America's Essential Hospitals a nationally representative survey of 2000 hospitals will be conducted to examine variation by HSSHDP status and other characteristics. Aim 2. Analyze changes (before, during, and after the COVID-19 pandemic, 2018-2023) in hospital- level quality, service levels, and finances, and in patient-level outcomes. Using secondary data sources, the study will focus on differences among HSSHDPs, and for context, compare HSSHDPs with non-HSSHDPs. Aim 3. Explore the challenges faced by HSSHDPs during the pandemic and the strategies pursued to overcome them. The study will include 12 in-depth case studies, using purposive sampling to select HSSHDPs and non-HSSHDPs with and without major effects due to COVID-19. Semi-structured interviews with stakeholders will be used to more fully understand existing structures, challenges, interactions with Coalitions, and other disaster management strategies. Aim 4. Develop prioritized policy recommendations to enhance resilience of our most critical public health systems for future disasters to protect the health of our most vulnerable populations and the facilities that serve them. A national Delphi consensus panel in conjunction with the National Academy of Science Engineering and Medicine will be conducted.

为健康差距人群服务的医院系统(HSSHDP)为种族和 少数民族和其他服务不足的社区。HSSHDP可能会经历自然环境的长期影响 以及人为灾难，这反过来可能会影响他们所服务的人群的健康结果。COVID- 大流行几乎影响了美国的每个医疗系统，因此提供了一个独特的机会 研究大规模和长期应激源对为弱势群体提供服务的资源不足系统的影响 患者群体。利用灾害管理周期的框架(减灾、备灾、 响应和恢复)，该项目建议对以下项目的长期影响进行混合方法研究 新冠肺炎在美国医院的四个关键领域(质量、劳动力、财务和创新)， 特别关注HSSHDP及其服务人群的健康差距。 该项目将是关于国家灾难对高SSHDPS影响的第一次重大国家调查。 这项严格的混合方法研究对于确定受影响最大和最小的HSSDHPS具有重要意义 新冠肺炎大流行，并将加深对导致成功和 挑战。这项研究将确定可操作的最佳做法和以前HSSHDPS运作面临的挑战， 在新冠肺炎大流行期间和之后。这项研究的具体目的是： 目标1.描述新冠肺炎对医院的长期影响以及感知的有用性 灾害管理规划活动(包括与联盟的互动)。与 美国医院协会与美国基本医院2000年全国代表性调查 医院将检查HSSHDP状态和其他特征的变化。 目标2.分析医院内(2018年至2023年新冠肺炎大流行之前、期间和之后)的变化- 质量水平、服务水平和财务水平，以及患者水平的结果。使用辅助数据源， 这项研究将侧重于HSSHDP之间的差异，并就背景而言，将HSSHDP与非HSSHDP进行比较。 目标3.探讨HSSHDP在大流行期间面临的挑战和采取的战略 去克服它们。这项研究将包括12个深入的案例研究，使用有目的的抽样来选择 有无新冠肺炎重大影响的HSSHDP和非HSSHDP。半结构化面试 将用于更全面地了解现有结构、挑战、与 联盟以及其他灾害管理战略。 目标4.制定优先政策建议，以增强我们最关键的公众的应变能力 应对未来灾害的卫生系统，以保护我们最脆弱人口的健康和 为他们服务的设施。与美国国家科学院联合成立的全国德尔福共识小组 将开设理工科和医学系。