Mobile Telecare for Underserved African-American Elders with Heart Failure

标题：为心力衰竭的非裔美国老年人提供移动电信服务 摘要 同时有资格享受医疗保险和医疗补助的老年人是病情最重和最贫穷的人之一 在这两个计划中都有。尽管他们的慢性病患病率要高得多，例如 心力衰竭(HF)超过所有其他医疗保险受益人，只有2%的双重符合条件的患者获得这种类型 病例管理或护理协调可以防止住院和急诊科就诊 治疗严重的医疗问题。非洲裔美国人尤其危险，他们患心力衰竭的比率最高。 与所有其他医疗保险受益人相比，住院人数。在第一阶段SBIR中，我们将进行一项试点 测试为符合条件的非裔美国双胞胎老年心力衰竭患者设计的护理协调计划的临床试验 已从地区医院出院并由社区卫生机构照顾的人 照顾者。建议的移动心脏护理协调(MHCC)计划整合了远程监护 通过支持蓝牙的设备和基于移动电话的通信技术 以医院为基础的心脏护理团队与基于社区的提供者。该计划的目标是提供 协调出院后护理，以减少潜在可避免的住院和急诊室 来访。这项第一阶段的SBIR将开发和测试MHCC干预的可行性和短期结果 患有心力衰竭的双重符合条件的非裔美国人。在第二阶段的应用中，我们将进行随机临床试验 与患有心力衰竭的非裔美国人双重资格的老年人一起确定MHCC的参与者- 增强计划不太可能在出院后30天内再次入院(主要假设) 与对照组相比，更不可能获得急诊室护理(次级假设) (照常护理)。第一阶段申请将提供必要的数据，以确定所需的样本量 第二阶段的更大规模的充分有效的随机对照试验。随后的第二阶段应用将 形成创新、经济高效且可在全国范围内推广的护理协调模式，旨在减少 潜在可避免的住院和急诊室就诊，以及提高所有非洲人的护理质量-- 美国符合双重条件的心衰患者。

Title: Mobile Telecare for Underserved African-American Elders with Heart Failure Abstract Older adults who are dually eligible for Medicare and Medicaid are among the sickest and poorest individuals covered in either program. Although they have a significantly higher prevalence of chronic conditions, such as heart failure (HF) than all other Medicare beneficiaries, as few as 2% of dual eligible patients receive the type of case management or care coordination that can prevent hospitalizations and emergency department visits for acute medical problems. African-Americans are particularly at risk, having the highest rates of HF-related hospitalizations compared to all other Medicare beneficiaries. In this Phase I SBIR, we will conduct a pilot clinical trial to test a care coordination program designed for African-American dual eligible older adults with HF who have been discharged from a regional hospital and who are being cared for by community-based health care providers. The proposed Mobile Heart Care Coordination (MHCC) program integrates telemonitoring through a Bluetooth-enabled device and mobile phone-based communication technologies that connect hospital-based cardiac care teams with community-based providers. The goal of the program is to provide coordinated post-discharge care in order to reduce potentially-avoidable hospitalizations and emergency room visits. This Phase I SBIR will develop and test the MHCC intervention's feasibility and short-term outcomes for dual eligible African-Americans with HF. In a Phase II application, we will conduct a randomized clinical trial with African-American dual-eligible older adults with HF to determine whether participants in the MHCC- enhanced program are less likely to be readmitted within 30 days of hospital discharge (primary hypothesis) and less likely to access emergency room care (secondary hypothesis) compared to the comparison group (usual care). The Phase I application will provide the necessary data to determine the sample size required for the larger adequately powered randomized controlled trial in Phase II. The subsequent Phase II application will result in an innovative, cost-effective, and nationally replicable care coordination model aimed at reducing potentially-avoidable hospitalizations and emergency room visits, and improving quality of care for all African- American dual eligible patients with HF.