Improving Health Outcomes for an Aging Population

其他项目信息-项目摘要/摘要 药物治疗及新冠肺炎对阿尔茨海默病等易感人群的影响 卫生政策和护理管理方面的干预措施有可能减少新冠肺炎感染和 死亡，特别是如果它们可以针对最脆弱的人群，如阿尔茨海默氏症患者 疾病及相关痴呆(ADRD)。在这份补充提案中，我们汇编信息并开发工具 可以加速并有针对性地进行此类干预。第一个目标是确定医疗和社会经济 使他们最容易受到新冠肺炎攻击的人的特征。我们创建了ADRD患者队列 以及基于2019年秋季特征的其他弱势群体，并跟踪他们到2020年 找出那些风险最高的人群，既有直接的新冠肺炎结局(如危重病、死亡率)，也有间接的后果风险 非COVID结果的增加。第二个目标是一个雄心勃勃的概念证明：使用自然实验 阐明治疗或预防新冠肺炎的新药，特别是 ADRD患者(例如，抗胆碱酯酶抑制剂)。我们将开发并应用机器学习方法来 测试药物类别对新冠肺炎的潜在影响，通过诊断、住院、ICU入院 和死亡。这一补充是由一个独特的机会实现的：获得近乎实时的联邦医疗保险索赔 数据(延迟一个月)，CMS似乎愿意通过加速数据使用协议提供这些数据。 该应用程序将补充正在进行的关于改善老年人健康结果的计划项目 他们的首要目标是更好地了解健康趋势和差距、健康的决定因素、 以及在不断变化的环境中改善老龄化人口健康的方法。

OTHER PROJECT INFORMATION – Project Summary/Abstract Drug Treatments and the Impact of COVID-19 on Alzheimer’s Patients and Other Vulnerable Populations Interventions in health policy and care management have the potential to reduce COVID-19 infections and deaths, particularly if they can be targeted to the most vulnerable populations such as patients with Alzheimer's Disease and Related Dementias (ADRD). In this supplement proposal, we compile information and develop tools that can accelerate and target such interventions. The first aim is to identify the medical and socioeconomic characteristics of people that make them most vulnerable to COVID-19. We create cohorts of patients with ADRD and for other vulnerable populations based on their Fall 2019 characteristics, and follow them through 2020 to identify those at greatest risk of both “direct” COVID-19 outcomes (e.g., critical illness, mortality) and “indirect” increases in non-COVID outcomes. The second aim is an ambitious proof of concept: using natural experiments to shed light on novel drugs to treat or prevent COVID-19 with a particular focus on drugs most heavily used by ADRD patients (e.g., anticholinesterase inhibitors). We will develop and apply a machine learning approach to test the potential effect of drug classes on COVID-19, measured by diagnosis, hospitalization, ICU admission, and death. This supplement is made possible by a unique opportunity: Access to near-real-time Medicare claims data (one-month lag), which CMS appears willing to make available through an expedited data use agreement. The application will supplement an ongoing program project on Improving Health Outcome for an Aging Population, whose overarching aim is to better understand health trends and disparities, determinants of health, and approaches to improving health for an aging population in an evolving landscape.