Long-Term Effects of COVID-19-induced Health Care Delivery Changes on Patient & Workforce Processes & Outcomes in Safety Net Practices Caring for Health Disparity Populations

COVID-19 引起的医疗保健服务变化对患者的长期影响

• 批准号: 10440740
• 负责人: Nicole Jill Cook
• 金额: $ 54.38万
• 依托单位: CASE WESTERN RESERVE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-08-21 至 2027-04-30
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10440740
• 关键词: Adoption; African American; Back; Budgets; COVID-19; COVID-19 pandemic; COVID-19 pandemic effects; Caring; Case Study; Chronic Care; Chronic Disease; Clinic; Communities; Community Health Networks; Computerized Medical Record; Country; Data; Decision Making; Depression screen; Disadvantaged; Disasters; Evolution; Financial Hardship; Health; Health Expenditures; Healthcare; Healthcare Systems; Home; Hour; Human; Information Technology; Insurance; Intervention; Interview; Knowledge; Laboratories; Language; Latino; Long-Term Effects; Measures; Medicaid; Movement; Natural Disasters; Natural experiment; Neighborhood Health Center; Outcome; Outpatients; Patient Care; Patient-Focused Outcomes; Patients; Persons; Population; Populations at Risk; Prenatal care; Preventive service; Primary Health Care; Process; Provider; Public Health Practice; Quality of Care; Refugees; Reporting; Research; Rural Health Centers; Sampling; Seasonal Variations; Social Change; Social Policies; Subgroup; Surveys; Telephone; Time Series Analysis; United States National Institutes of Health; Visit; Work; acute care; base; birth control; comparative; cost; disparity reduction; experimental study; follow-up; functional status; health care delivery; health care disparity; health disparity; health disparity populations; health equity; health inequalities; improved; innovation; insight; long term consequences of COVID-19; low socioeconomic status; multiple chronic conditions; novel; outreach; pandemic disease; patient registry; personalized care; population health; practice-based research network; remote visit; reproductive; response; safety net; secondary analysis; service delivery; telehealth; tool; Adoption; African American; Back; Budgets; COVID-19; COVID-19 pandemic; COVID-19 pandemic effects; Caring; Case Study; Chronic Care; Chronic Disease; Clinic; Communities; Community Health Networks; Computerized Medical Record; Country; Data; Decision Making; Depression screen; Disadvantaged; Disasters; Evolution; Financial Hardship; Health; Health Expenditures; Healthcare; Healthcare Systems; Home; Hour; Human; Information Technology; Insurance; Intervention; Interview; Knowledge; Laboratories; Language; Latino; Long-Term Effects; Measures; Medicaid; Movement; Natural Disasters; Natural experiment; Neighborhood Health Center; Outcome; Outpatients; Patient Care; Patient-Focused Outcomes; Patients; Persons; Population; Populations at Risk; Prenatal care; Preventive service; Primary Health Care; Process; Provider; Public Health Practice; Quality of Care; Refugees; Reporting; Research; Rural Health Centers; Sampling; Seasonal Variations; Social Change; Social Policies; Subgroup; Surveys; Telephone; Time Series Analysis; United States National Institutes of Health; Visit; Work; acute care; base; birth control; comparative; cost; disparity reduction; experimental study; follow-up; functional status; health care delivery; health care disparity; health disparity; health disparity populations; health equity; health inequalities; improved; innovation; insight; long term consequences of COVID-19; low socioeconomic status; multiple chronic conditions; novel; outreach; pandemic disease; patient registry; personalized care; population health; practice-based research network; remote visit; reproductive; response; safety net; secondary analysis; service delivery; telehealth; tool

Long-Term Effects of COVID-19-induced Health Care Delivery Changes on Patient & Workforce Processes & Outcomes in Safety Net Practices Caring for Health Disparity Populations ABSTRACT / PROJECT SUMMARY Primary care provides more than half of all outpatient visits ― 500 million each year ― with only 30% of the healthcare workforce and <6% of national healthcare expenditure, informed by only 0.2% of the NIH research budget. Healthcare systems based on primary care have healthier populations, greater equity, and lower costs. Our ongoing national practice and patient surveys show that the pandemic and resulting ongoing health care system and social changes are having a devastating effects on the primary care workforce and its ability to integrate and personalize care in a fragmented, impersonal, inequitable healthcare system. Yet, amidst the COVID-19 natural disaster, ongoing primary care innovations provide hope for advancing equity for health disparity populations. We have a unique opportunity to study the effects of the pandemic in a national network of 926 community health centers serving >2.6 million patients from health disparity populations. The proposed study will: 1) Identify changes in health care delivery to health disparity populations in community health centers in response to the continuing practice, social and policy changes launched by the COVID-19 pandemic; 2) Assess the longitudinal impact of these practice changes on care quality in health disparity populations; 3) Examine the ongoing effects of these changes on community health center workforce stability; 4) Identify promising strategies to improve healthcare equity after a natural disaster & varied human response. In response to PA-20-172: Long-Term Effects of Disasters on Health Care Systems Serving Health Disparity Populations, we will conduct a time series analysis of practice changes and associated patient and workforce outcomes initiated by the COVID-19 pandemic and the ongoing changes stimulated by it. Monthly analyses will examine longitudinal changes in practice processes, patient outcomes, and workforce stability for health disparity and other at-risk populations. For a five-year period going back to January 2020 ― the month of the first known COVID-19 case in the US and the start of responding public health and practice changes ― we will analyze and publicly report, on a monthly basis, practice changes and patient outcomes, to rapidly inform decision making about primary care of health disparity populations. Subgroup analyses will examine differences across 26 states that have had different societal responses to the pandemic. The findings from these quantitative analyses of millions of patients being seen in hundreds of community health centers also will be used to identify a purposive sample of exemplars and contrasting practices for in-depth case studies of practice innovations that show promise in reducing healthcare disparities. Findings will generate vital new knowledge on the longitudinal effect of a pandemic on care provided to health disparity populations and on the sustainability of the primary care community health center workforce, and will inform efforts to improve health care equity after a natural disaster and varied human responses.

COVID-19诱导的医疗保健提供变化对患者和劳动力的长期影响 安全网的过程和结果照顾健康差异人群 摘要 /项目摘要 初级保健提供所有门诊就诊的一半以上 - 每年5亿美元 - 只有30％ 医疗保健劳动力和<6％的国家医疗保健支出，仅占NIH的0.2％ 研究预算。基于初级保健的医疗保健系统具有更健康的人口，更大的股权和 降低成本。我们正在进行的国家实践和患者调查表明，大流行和导致的 医疗保健系统和社会变革对初级保健劳动力及其造成毁灭性影响 能够在零散，非个人化，不平等的医疗保健系统中整合和个性化护理的能力。 然而，在共同的19自然灾害中，正在进行的初级保健创新为希望提供了希望 促进健康差异人群的股权。我们有一个独特的机会来研究 在一个由926个社区卫生中心的国家网络中，大流行，卫生患者为260万患者 差异人群。拟议的研究将： 1）确定在社区卫生中心的健康差异人群中提供的医疗保健交付变化 对持续的实践，社会和政策变化的反应，共同于19日大流行； 2）评估这些实践变化对健康差异人群中护理质量的纵向影响； 3）检查这些变化对社区卫生中心劳动力稳定的持续影响； 4）确定自然灾害和各种人类反应后改善医疗保健的承诺策略。 响应PA-20-172：灾害对服务健康的医疗保健系统的长期影响 差异人群，我们将对实践变化和相关患者进行时间序列分析， COVID-19大流行和IT刺激的持续变化发起的劳动力成果。每月 分析将检查实践过程中的纵向变化，患者结果和劳动力稳定性 健康差异和其他高危人群。五年可追溯到2020年1月 - 这个月 在美国第一个已知的COVID案件中 我们将每月分析和公开报告练习和患者的结果，以迅速 告知有关健康差异人群初级护理的决策。亚组分析将检查 在26个国家对大流行的社会反应不同的州之间的差异。来自 这些对数百个社区卫生中心中看到的数百万患者的定量分析也将 用于确定自然样本的示例样本和对比鲜明的做法，以深入研究 练习创新，这些创新在减少医疗保健分配方面有希望。 调查结果将对大流行对提供的护理的纵向影响产生重要的新知识 健康差异人群以及初级保健社区健康中心劳动力的可持续性， 并将为自然灾害和人类反应多样的努力提供改善医疗保健公平的努力。