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
• 负责人: Jie Chen
• 金额: $ 57.97万
• 依托单位: UNIV OF MARYLAND, COLLEGE PARK
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-03-01 至 2025-02-28
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10589023
• 关键词: Address; Adoption; Affect; African American population; Age; Aging; Alzheimer' s Disease; Alzheimer' s disease diagnosis; Alzheimer' s disease related dementia; Alzheimer' s disease risk; American; American Hospital Association; Area; Caregivers; Caring; Chronic Care; Chronic Disease; Communities; Community Health; Community Healthcare; Community Hospitals; Community Surveys; Continuity of Patient Care; Data; Data Set; Databases; Dementia; Diabetes Mellitus; Diagnosis; Disease; Disease Progression; Disparity; Disparity population; Ensure; Equity; Face; Feasibility Studies; Goals; Health; Health Care Costs; Health Personnel; Health Resources; Health system; Healthcare Systems; Healthcare promotion; Hispanic Populations; Homelessness; Hospitals; Housing; Hypertension; Individual; Investments; Latino Population; Link; Longitudinal Studies; Managed Care; Medicare; Medicare claim; Mental Health; Mission; National Health Interview Survey; Obesity; Organizational Models; Outcome; Patient-Centered Care; Patients; Persons; Policies; Policy Maker; Population; Primary Care; Public Health; Quality of Care; Reduce health disparities; Research; Resources; Risk Factors; Service delivery model; Services; Skilled Nursing Facilities; Social Work; Structure; Surveys; Systems Integration; U.S. Department of Housing and Urban Development; Underserved Population; United States National Center for Health Statistics; accountable care organization; acute care; beneficiary; care coordination; community organizations; comorbidity; cost effective; data infrastructure; design; disparity reduction; economic incentive; effective care management; ethnic disparity; ethnic minority; ethnic minority population; experience; health assessment; health care availability; health care delivery; health care quality; hospital care; improved; innovation; interest; modifiable risk; population health; programs; racial disparity; racial minority; racial minority population; social health determinants; supported housing

Project Summary: Addressing racial and ethnic disparities in ADRD through the integration of local public health departments and health systems is a strategic priority, according to The National Plan to Address Alzheimer's Disease 2019. Such integration is expected to address social determinants of health and promote culturally-valid population health assessments and treatment. Investments in care coordination practices and innovative health care delivery models, such as Accountable Care Organizations (ACOs), represent an important opportunity for promoting continuity of care for people with ADRD and risk factors for ADRD. There is an urgent need to understand effective care coordination practices for racial and ethnic minority ADRD patients across hospital, community, and public health systems, and how to improve such coordination systematically through innovative health care delivery models. Our long-term goal is to build a hospital-community integrated system that delivers personalized patient-centered care to promote population health and reduce health disparities for people with ADRD and risk factors for ADRD. The objective of this project is to identify hospital- community care coordination practices and the innovative features of health care delivery models that can improve effective management of ADRD; control/reduce modifiable risk factors of; and eventually promote population health and reduce health disparities. Our central hypothesis is that integrating hospital and community care with the support of ongoing policy initiatives that promote the adoption of care coordination, such as ACOs, can significantly improve health care quality and equity. We are particularly interested in understanding how care coordination can improve care quality for racial and ethnic minorities. An additional population of interest is among the hardest-to-reach populations: racial and ethnic minorities who receive federal housing assistance (through the Department of Housing and Urban Development (HUD)) and who may have experienced periods of homelessness. We aim to identify hospital-community care coordination practices that can improve quality of care, reduce health care costs, and reduce racial and ethnic disparities (Aim 1); determine the extent to which ACO models can promote care coordination practices and reduce disparities among Medicare beneficiaries with ADRD and beneficiaries who are at an increased risk for ADRD (Aim 2); and estimate the impact of care coordination practices and ACO models on health care quality and disparities reduction among HUD-assisted populations with ADRD and populations who are at an increased risk for ADRD (Aim 3). Our aims are formulated on the basis of our preliminary findings produced under current NIA support (R56AG062315). The results of our study are expected to provide evidence on cost-effective care coordination practices that can make care integration sustainable for racial and ethnic minority populations, and break down longstanding silos and bridge the gap between hospitals, health care providers, and the public health system for people with ADRDs and risk factors of ADRDs.

项目概述：通过融入当地公众，解决ADRD中的种族和民族差异

项目成果

Trends in Health Care Utilization and Expenditures in the United States Across 5 Decades: 1977-2017.

• DOI: 10.1097/mlr.0000000000001557
• 发表时间: 2021-08-01
• 期刊: Medical care
• 影响因子: 3
• 作者: Mortensen K;Dean EB;French MT;Wang N;Chen J
• 通讯作者: Chen J

Disparities in Audio-only Telemedicine Use Among Medicare Beneficiaries During the Coronavirus Disease 2019 Pandemic.

• DOI: 10.1097/mlr.0000000000001631
• 发表时间: 2021-11-01
• 期刊: Medical care
• 影响因子: 3
• 作者: Benjenk I;Franzini L;Roby D;Chen J
• 通讯作者: Chen J

Inequities in Access to Care and Health Care Spending for Asian Americans With Cancer.

• DOI: 10.1097/mlr.0000000000001538
• 发表时间: 2021-06-01
• 期刊: Medical care
• 影响因子: 3
• 作者: Park S;Chen J;Ma GX;Ortega AN
• 通讯作者: Ortega AN

Collaborating for COVID-19: Hospital Health Information Exchange and Public Health Partnership.

合作应对 COVID-19：医院健康信息交换和公共卫生伙伴关系。

• DOI: 10.1089/tmj.2023.0056
• 发表时间: 2024
• 期刊: Telemedicine journal and e-health : the official journal of the American Telemedicine Association
• 作者: Maguire,TeaganKnapp;Yoon,Sunjung;Chen,Jie
• 通讯作者: Chen,Jie

Accountable Care Hospitals and Preventable Emergency Department Visits for Rural Dementia Patients.

• DOI: 10.1111/jgs.16858
• 发表时间: 2021-01
• 期刊: Journal of the American Geriatrics Society
• 影响因子: 6.3
• 作者: Wang N;Amaize A;Chen J
• 通讯作者: Chen J