Understanding Coordinated Care for Children with Complex Chronic Conditions

了解患有复杂慢性病的儿童的协调护理

• 批准号: 7923949
• 负责人: Savithri Nageswaran
• 金额: $ 18.5万
• 依托单位: WAKE FOREST UNIVERSITY HEALTH SCIENCES
• 依托单位国家: 美国
• 财政年份: 2009
• 资助国家: 美国
• 起止时间: 2009-09-01 至 2012-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7923949
• 关键词: Address; Caring; Child; Child Care; Chronic; Chronic Care; Clinical; Collaborations; Communication; Communities; Complex; County; Data; Effectiveness; Evaluation; Fostering; Healthcare Systems; Healthy People 2010; Individual; Information Systems; Measures; Medical; Methodology; Modeling; Pathway Analysis; Provider; Public Health; Science; Services; Social Network; Social Work; Surveys; System; Techniques; Testing; Time; base; design; improved; innovation; public health relevance; therapy design

DESCRIPTION (provided by applicant): Children with complex chronic conditions (CCC) receive care from diverse medical, educational and social service providers through various agencies for a prolonged period of time. Coordination of care between agencies serving these children is lacking, resulting in gaps and inefficiencies in care. Developing systems of coordinated care for children with special needs in communities is a Healthy People 2010 Objective. To develop systems of coordinated care we need information on how agencies providing care to children with CCC collaborate with one another. We propose to evaluate the existing system of coordinated care among agencies that serve children with CCC in Forsyth County, NC using an innovative methodology called social network analysis. The Specific Aims are: (1) to evaluate the extent of collaborative relationships that currently exist among agencies that serve children with CCC, (2) to identify agency-level factors and communication linkages that improve collaborative relationships with other agencies, and (3) to test, using longitudinal observational data, whether participating in a community coalition that focuses on improving care of children with CCC increases collaborative relationships with other agencies. We will analyze survey data from agencies using social network analytical techniques. The dependent measure is the 'tie of collaborative relationship' between one agency and another within the collaboration network for CCC. First, we will describe the collaboration network. Next, we will evaluate agency-level factors that improve collaborative relationships, with a focus on the presence of a care coordinator and communication linkages. Finally, we will assess effectiveness of community coalition in improving collaborative relationships at one year compared to baseline. The results of this study will enhance our understanding of the existing system of coordinated care for CCC and identify factors that improve such care. Results of this study will be used to design interventions to improve care coordination for children with CCC. In addition, this study will provide empirical evidence for effectiveness of community coalitions in improving collaboration between agencies and advance the science of evaluation of the health-care system. PUBLIC HEALTH RELEVANCE: This proposal addresses the issue of care coordination for children with complex chronic conditions, which is an important public health problem in the U.S. The results of this project will enhance our understanding of the existing system of coordinated care for children with CCC and help identify factors that foster collaborative relationships between agencies serving these children. Results of this study will be used to design interventions to improve care coordination for children with CCC.

描述（由申请人提供）：患有复杂慢性病（CCC）的儿童通过各种机构长期接受各种医疗，教育和社会服务提供者的护理。为这些儿童提供服务的机构之间缺乏协调，造成护理方面的差距和效率低下。为社区有特殊需要的儿童建立协调护理系统是“健康人民2010”目标。为了建立协调护理系统，我们需要了解为CCC儿童提供护理的机构如何相互合作。我们建议评估现有的协调照顾机构之间的系统，服务于儿童CCC在福赛斯县，NC使用一种创新的方法，称为社会网络分析。具体目标是：（1）评估目前为儿童保育服务的机构之间的合作关系的程度，（2）确定机构一级的因素和沟通联系，以改善与其他机构的合作关系，（3）使用纵向观察数据进行测试，是否参与社区联盟，重点是改善儿童保育与CCC增加与其他合作关系社.我们将使用社交网络分析技术分析来自机构的调查数据。依赖性的衡量标准是CCC合作网络中一个机构与另一个机构之间的“合作关系纽带”。首先，我们将描述协作网络。接下来，我们将评估改善合作关系的机构层面因素，重点是护理协调员和沟通联系的存在。最后，我们将评估社区联盟在一年内与基线相比改善合作关系的有效性。这项研究的结果将提高我们对现有的CCC协调护理系统的理解，并确定改善这种护理的因素。本研究的结果将被用来设计干预措施，以改善与CCC儿童的护理协调。此外，这项研究将提供经验证据，社区联盟在改善机构之间的合作和推进科学的评估医疗保健系统的有效性。公共卫生关系：该提案解决了复杂慢性病儿童的护理协调问题，这是美国一个重要的公共卫生问题。该项目的结果将增强我们对现有CCC儿童协调护理系统的理解，并有助于确定促进为这些儿童服务的机构之间合作关系的因素。本研究的结果将被用来设计干预措施，以改善与CCC儿童的护理协调。