Burdens of multimorbidity on hospitalization and mortality in nursing home residents with obesity

项目总结 养老院的居民和所有年龄段的美国人一样，越来越多地遭受肥胖症的困扰。患肥胖症 经常出现其他慢性病，包括心血管疾病、糖尿病、关节炎、 还有一些癌症。与正常体重的人相比，肥胖的居民体验到更多的疼痛 通常情况下，从椅子上站起来、走路和保持平衡都比较困难。因此，关爱 养老院的提供者越来越多地面临同时管理多个慢性疾病的前景 这些居民的条件和功能限制。使用国家最低数据集(MDS)和 医疗保险提供者分析和审查(MedPAR)文件(2012-2015)，此R03项目旨在1)描述 肥胖症疗养院居民的多发病星座。这将包括：a)识别 上述并发条件中最常见的1、2、3、4、5或5；以及b)区分 I级、II级和III级肥胖居民的多发病情况。2)评估以下项目的影响 在A1中发现的多发病，是在患有肥胖症的疗养院居民中死亡的。3)评估以下项目的影响 在A1中发现了肥胖疗养院居民住院的多发病。这项研究将 提供疗养院居民中流行疾病星座的描述信息 肥胖症，并找出这些人中有可预防的住院和死亡高风险的亚群。 研究结果将为临床医生提供支持，帮助他们了解如何有针对性地进行干预以改善护理 高危人群中的个人。这项研究针对的是卫生与公众服务部2010年 关于多种慢性病的战略框架，该框架呼吁进行研究，以“了解 多种慢性病“(目标4，目标B)，补充了目前关于”多种慢性病“的有限研究。 最普遍和最重要的…条件星座[和]通知有效 干预措施。“

PROJECT SUMMARY Nursing home residents, like Americans of all ages, suffer increasingly from obesity. Obesity develops frequently in the presence of other chronic conditions, including cardiovascular diseases, diabetes, arthritis, and some cancers. Compared to those with normal weight, residents with obesity experience more pain with activity, and typically have more difficulty rising from a chair, walking, and maintaining balance. Thus, care providers in nursing homes increasingly face the prospect of simultaneously managing multiple chronic conditions and functional limitations among these residents. Using national Minimum Data Set (MDS) and Medicare Provider Analysis and Review (MedPAR) files (2012-2015), this R03 project aims to 1) characterize constellations of multimorbidity among nursing home residents with obesity. This will include: a) identifying the most common 1, 2, 3, 4, 5, or 5 above concurrent conditions; and b) distinguishing patterns of constellations of multimorbidity among residents with class I, class II and class III obesity, respectively. 2) assess the impact of multimorbidity, found in A1, on death among nursing home residents with obesity. 3) assess the impact of multimorbidity, found in A1, on hospitalization among nursing home residents with obesity. This study will provide descriptive information of constellations of prevalent conditions among nursing home residents with obesity, and identify subgroups of these individuals at high risk of preventable hospitalization and of mortality. The study results will support clinicians with insight about how interventions to improve care can be targeted to individuals in high-risk groups. This study addresses the Department of Health and Human Services' 2010 Strategic Framework on Multiple Chronic Conditions, which calls for studies to “understand the epidemiology of multiple chronic conditions” (Goal 4, Objective B) and augment the currently limited research about “the constellations of conditions that are most prevalent and most important …[and] to inform effective interventions.”