Midcareer Mentoring Award for Patient-Oriented Research in Aging

以患者为导向的老龄化研究职业生涯中期指导奖

• 批准号: 9064734
• 负责人: Rachel M Werner
• 金额: $ 21.03万
• 依托单位: UNIVERSITY OF PENNSYLVANIA
• 依托单位国家: 美国
• 财政年份: 2014
• 资助国家: 美国
• 起止时间: 2014-09-15 至 2020-04-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9064734
• 关键词: Address; Aging; American; Award; Caliber; Caring; Chronic; Chronic Disease; Clinical Trials; Complex; Coupled; Data Set; Disease; Effectiveness; Elderly; Evaluation; Funding; Goals; Government; Health; Health Care Costs; Health Personnel; Health Policy; Healthcare; Hospitalization; Hospitals; Impact evaluation; Incentives; Individual; Intervention; Investigation; Measurement; Measures; Medicaid; Mentors; Mentorship; Mid-Career Clinical Scientist Award (K24); Nursing Homes; Observational Study; Outcome; Patient Care; Patients; Performance; Policies; Population; Primary Health Care; Provider; Publishing; Quality of Care; Randomized Controlled Trials; Research; Research Infrastructure; Research Methodology; Research Personnel; Rewards; Role; Skilled Nursing Facilities; System; Testing; Training; Training Programs; United States Agency for Healthcare Research and Quality; Work; base; care delivery; clinical practice; cost; design; health care delivery; improved; innovation; older patient; patient oriented; patient oriented research; payment; prevent; programs; randomized trial

DESCRIPTION (provided by applicant): With the aging of the U.S. population, enormous efforts have been devoted to reforming health care delivery to optimize the cost-quality tradeoff for older adults, including publishing quality information on health care providers altering payment systems to reward the quality and value of care and transforming primary care delivery to focus on patient-centered, high-value care. Yet relatively little is known about whether these changes achieve their goal of improving care for older Americans and, if not, how to improve them so they do. My current research makes innovative use of national datasets to conduct rigorous evaluations of the impact of these policies on the care for older adults. These studies have evaluated whether or not quality measures and incentives aimed at improving quality of care for older patients work, what aspects of these measures and incentives works versus doesn't work, and how to improve quality measurement and incentives. This research has provided practical lessons on ways to improve quality improvement initiatives, has informed the planning and implementation of new innovative delivery systems, and has had a significant impact on clinical practice and policy for older adults. I aim to continue conducting this research Looking forward, I also aim to expand my research program from examining the impact of health care policies on older adults to implementing and evaluating health care delivery innovations designed to improve the health and wellbeing of older adults~ and to use my research program to train and mentor new investigators in the field of improving health care delivery for older adults. Thus, the SPECIFIC AIMS of this proposal are: 1) To conduct high-quality research examining the impact of health care policies and delivery systems on quality of care for older adults with chronic and complex illness, with the goal of improving the quality with a new direction on the design and testing of innovative health care delivery interventions to improve patient care. This aim will be accomplished through the completion of currently funded observational studies focusing on improving the use of quality measures and incentives in nursing homes and the conduct of new intervention-based studies of delivery transformation. And 2) To use my research as a platform to mentor new investigators in improving health care delivery for older adults, to help them become independent investigators and support the expansion of the field with well-trained patient-oriented researchers in aging. This aim will be accomplished through direct involvement of my trainees in my ongoing and new observational studies and clinical trials~ leveraging my programmatic research infrastructure to enable my mentees' investigations~ and ongoing recruitment of high-caliber mentees to my research and mentoring program. My overall goal is to improve the quality of care for older adults with chronic and complex diseases. Ultimately, my ongoing and proposed research, coupled with my mentorship program to train outstanding investigators in the field, is designed help address the critical need to reform the health care delivery system to efficiently bring high quality care to te millions of aging Americans in need of better care.

描述（由申请人提供）：随着美国人口的老龄化，人们付出了巨大的努力来改革医疗保健服务，以优化老年人的成本-质量权衡，包括发布有关医疗保健提供者的质量信息，改变支付系统以奖励护理的质量和价值，并将初级保健服务转变为以患者为中心的高价值护理。然而，人们对这些变化是否实现了改善美国老年人护理的目标知之甚少，如果没有，如何改善他们这样做。 我目前的研究创新性地利用了国家数据集，对这些政策对老年人护理的影响进行了严格的评估。这些研究评估了旨在提高老年患者护理质量的质量措施和激励措施是否有效，这些措施和激励措施的哪些方面有效，哪些方面无效，以及如何提高质量措施和激励措施。 这项研究为提高质量改进措施提供了实践经验，为新的创新交付系统的规划和实施提供了信息，并对老年人的临床实践和政策产生了重大影响。我的目标是继续进行这项研究展望未来，我还打算扩大我的研究计划，从检查医疗保健政策对老年人的影响，以实施和评估旨在改善老年人健康和福祉的医疗保健服务创新，并利用我的研究计划来培训和指导新的调查人员，以改善老年人的医疗保健服务。因此，该提案的具体目标是：1）进行高质量的研究，检查医疗保健政策和提供系统对患有慢性和复杂疾病的老年人护理质量的影响，目标是通过设计和测试创新医疗保健提供干预措施以改善患者护理的新方向来提高质量。这一目标将通过完成目前资助的观察性研究来实现，这些研究的重点是改善疗养院质量措施和奖励措施的使用，并进行新的基于干预的分娩转变研究。2）利用我的研究作为一个平台，指导新的研究人员改善老年人的医疗保健服务，帮助他们成为独立的研究人员，并支持该领域的扩展与训练有素的面向患者的研究人员在老龄化。这一目标将通过我的学员直接参与我正在进行的和新的观察性研究和临床试验来实现，利用我的计划研究基础设施，使我的学员能够进行研究，并不断招募高素质的学员参加我的研究和指导计划。我的总体目标是提高患有慢性和复杂疾病的老年人的护理质量。最终，我正在进行的和拟议的研究，加上我的导师计划，以培养该领域的优秀调查人员，旨在帮助解决迫切需要改革医疗保健提供系统，有效地带来高质量的护理，以满足数百万需要更好的护理的美国老年人。