Disparities in Diabetes Care: Health Plan Focus and Physician Responsiveness

糖尿病护理的差异：健康计划的重点和医生的反应

• 批准号: 7880572
• 负责人: Connie Mah Trinacty
• 金额: $ 15.34万
• 依托单位: HARVARD PILGRIM HEALTH CARE, INC.
• 依托单位国家: 美国
• 财政年份: 2009
• 资助国家: 美国
• 起止时间: 2009-07-01 至 2014-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7880572
• 关键词: Disparities; Diabetes; Care; Health; Plan

DESCRIPTION (provided by applicant): Connie Mah Trinacty, PhD, is a health services researcher committed to a research career investigating strategies to address health disparities in care and outcomes for chronically ill patients. A K01 award will build upon a strong foundation of prior training and research, and provide necessary advanced education and experience through a multidisciplinary team of expert mentors and advisors and the outstanding resources of Harvard University. Valuable exploratory research experience will be gained in learning how organizational processes, actions, and structure in two large, differently structured health plans influence the adoption and sustainability of initiatives to address disparities (i.e., race/ethnicity, income, education) among their diabetes members. In recent years, health care disparities and quality improvement have become high priority research areas. In spite of increasing attention on addressing disparities, few empirical studies demonstrate sustainable success in reducing disparities in quality of care and outcomes for vulnerable diabetes populations. The influence of health systems in efforts to reduce disparities is not well understood, particularly in managed care organizations. The proposed research will identify and explore key health plan organizational factors (e.g., quality measurement process, product development and marketing strategies, participation in national disparities collaboratives) that may affect disparities; assess how well commonly used performance measures reflect underlying disparities in health care quality and outcomes among diabetes patients; and evaluate how providers' awareness and responsiveness to systems-based quality initiatives may impact differences in patient management. Through a mixed-methods approach to understand the complexity of health plan system structures and processes by which system-wide initiatives are implemented, this research program may shed light on why current efforts in eliminating existing disparities fail to realize their potential. In addition, this program will provide the foundation for Dr. Trinacty's transition to an independent investigator in the field of health disparities, with a focus on the linkages between systems, providers, and initiatives to reduce disparities for diabetes patients.

描述（由申请人提供）：Connie Mah Trinacty 博士是一名卫生服务研究员，致力于研究解决慢性病患者护理和结果方面健康差异的策略。 K01 奖项将建立在先前培训和研究的坚实基础上，并通过专家导师和顾问组成的多学科团队以及哈佛大学的优秀资源提供必要的先进教育和经验。通过了解两个大型、结构不同的健康计划中的组织流程、行动和结构如何影响解决糖尿病成员之间差异（即种族/民族、收入、教育）的举措的采用和可持续性，将获得宝贵的探索性研究经验。近年来，医疗保健差异和质量提高已成为高度优先的研究领域。尽管人们越来越关注解决差异问题，但很少有实证研究表明在减少弱势糖尿病人群的护理质量和结果差异方面取得了可持续的成功。卫生系统在减少差异方面的影响尚不清楚，特别是在管理式医疗组织中。拟议的研究将确定和探索可能影响差异的关键健康计划组织因素（例如，质量测量过程、产品开发和营销策略、参与国家差异合作）；评估常用的绩效衡量标准如何反映糖尿病患者医疗保健质量和结果的潜在差异；并评估提供者对基于系统的质量举措的认识和响应能力如何影响患者管理的差异。通过采用混合方法来了解卫生计划系统结构和实施全系统举措的流程的复杂性，该研究计划可能会揭示为什么当前消除现有差异的努力未能发挥其潜力。此外，该计划将为 Trinacty 博士转变为健康差异领域的独立调查员奠定基础，重点关注系统、提供者和减少糖尿病患者差异的举措之间的联系。