Infrastucture for CER on Innovative Delivery Systems for Complex Patients

描述（由申请人提供）：该项目将建立一个全州范围的数据基础设施，用于低收入社区复杂患者的医疗保健服务创新的比较有效性研究（CER）。它解决了医学研究所在2009年建立的两个CER优先事项，以评估以下结果：（1）“......综合护理协调方案，如医疗之家，在管理患有严重慢性病的儿童和成人，特别是在已知健康差距的人群中”;和（2）“负责任的护理系统.对于患有一种或多种慢性疾病的患者的地理定义人群。“为了响应医疗保健研究和质量机构的申请（RFA-HS-10-001），以扩大研究能力，研究复杂患者的比较有效性，该项目有三个具体目标：1。在新泽西建立一个可持续的纵向数据库，其中包括医院、医疗补助和慈善护理索赔以及遭遇记录，以用于CER改善低收入社区复杂患者护理服务的战略。2.使用根据目标1开发的数据库，为低收入社区复杂患者的创新交付系统的CER建立和评估资源使用和护理质量的指标。3.通过对新泽西州卡姆登创新护理协调计划服务的复杂患者的卫生服务资源使用和质量进行试点评估，展示这种新研究基础设施的潜力。数据基础设施旨在成为一个持续的企业，最初将包括六年的国家计划行政记录。这项工作的成果将广泛传播，数据库将公布供公众使用。该项目建立在大学研究人员和新泽西政府机构之间的长期合作基础上，并将在鼓励低收入城市人口医疗保健服务创新的州政策背景下进行。新泽西特别适合CER对卫生系统提供创新，因为它有非常高的比率，可预防利用昂贵的医院护理。 公共卫生相关性：低收入社区中健康状况复杂的患者经常经历不充分和分散的卫生服务，导致可避免地使用昂贵的医院护理和不良结果。该项目将建立研究能力，比较医疗保健提供系统创新的成本和质量，以照顾通常收到的医疗复杂的病人在新泽西低收入社区。

DESCRIPTION (provided by applicant): This project will establish a statewide data infrastructure for Comparative Effectiveness Research (CER) on healthcare delivery innovations for complex patients in low-income communities. It addresses two CER priorities established by the Institute of Medicine in 2009 to evaluate outcomes of: (1) "...comprehensive care coordination programs, such as the medical home, in managing children and adults with severe chronic disease, especially in populations with known health disparities"; and (2) "accountable care systems ...for geographically defined populations of patients with one or more chronic diseases." Responding to the Agency for Healthcare Research and Quality request for applications (RFA-HS-10-001) to expand research capability to study comparative effectiveness in complex patients, this project has three specific aims: 1. Build a sustainable longitudinal database of linked hospital, Medicaid, and charity care claims and encounter records in New Jersey for CER on strategies to improve the delivery of care to complex patients in low-income communities. 2. Build and evaluate measures of resource use and quality of care for CER on innovative delivery systems for complex patients in low-income communities using the database developed under Aim 1. 3. Demonstrate the potential of this new research infrastructure by conducting a pilot evaluation of health services resource use and quality for complex patients served by an innovative care coordination program in Camden, NJ. Designed to become an ongoing enterprise, the data infrastructure will initially consist of six years of state program administrative records. Products of this work will be disseminated widely and the database will be released for public use. The project builds on a long-standing collaboration between university researchers and agencies of New Jersey government, and will take place in the context of state policies encouraging innovation in health care delivery for low-income urban populations. New Jersey is especially well suited to CER on health system delivery innovations because it has exceptionally high rates of preventable utilization of expensive hospital care. PUBLIC HEALTH RELEVANCE: Patients with complex health conditions in low-income communities frequently experience inadequate and fragmented health services, leading to avoidable use of expensive hospital care and poor outcomes. This project will build research capacity to compare the cost and quality of health care delivery system innovations to care typically received by medically complex patients in low-income communities in New Jersey.