Disparties in Nursing Home Care by Race and Payer Status

描述（由申请人提供）：本导师研究科学家发展奖（K01）的目的是为刚毕业的卫生经济学家候选人提供额外的培训和研究经验，使他能够在老年人的学术生涯中专注于养老院质量护理问题的经济学。为了充分理解和调查患者水平的质量措施，候选人将需要获得专业知识和技能。他提出了一个职业发展计划，由资深教师组成的指导团队将提供临床、测量和建模方面的专业知识，以使用患者水平的数据。研究计划包括疗养院护理质量的设施内变化的研究。本研究的第一个目的是测试疗养院护理和养老院结果的差异是否存在于医疗补助和私人支付的居民在一个共同的设施。本研究的第二个目的是评估疗养院护理和养老院结果的差异是否存在于同一设施内的少数民族和多数种族居民之间。通过使用最近多年的MDS数据，本研究将大大增加我们对付款人身份和种族在养老院质量差异的理解。研究结果将使提供者、倡导者、临床医生、消费者和政策制定者能够更好地评估和解决养老院护理中的设施内差异。

DESCRIPTION (provided by applicant): The purpose of this Mentored Research Scientist Development Award (K01) is to provide the candidate, a recently graduated health economist, with additional training and research experience that will enable him to pursue an academic career in aging with a focus on the economics of nursing home quality care issues. In order to fully understand and investigate patient-level quality measures, the candidate will need to acquire specialized knowledge and skills. He proposes a career development plan with a mentoring team of senior faculty that will provide clinical, measurement, and modeling expertise in the use of patient-level data. The research program consists of a study of within-facility variation in the quality of nursing home care. The first aim of this study tests whether disparities in nursing home care and nursing home outcomes exist across Medicaid and private-pay residents within a common facility. The second aim of this study evaluates whether disparities in nursing home care and nursing home outcomes exist across racial and ethnic minority and majority residents within a common facility. By using recent MDS data over multiple years, the proposed study will greatly increase our understanding of differences in nursing home quality by payer status and race. The results will allow providers, advocates, clinicians, consumers and policymakers to better evaluate and address within-facility disparities in nursing home care.