Regulatory Reforn and Angiography Disparties

监管改革和血管造影的分歧

基本信息

  • 批准号:
    6924520
  • 负责人:
  • 金额:
    $ 23.17万
  • 依托单位:
  • 依托单位国家:
    美国
  • 项目类别:
  • 财政年份:
    2004
  • 资助国家:
    美国
  • 起止时间:
    2004-08-01 至 2007-07-31
  • 项目状态:
    已结题

项目摘要

DESCRIPTION (provided by applicant): Beginning in 1996, New Jersey embarked on hospital regulatory reforms that addressed, among other goals, the long-standing problem of racial and ethnic disparities in use of cardiac angiography (CA). These reforms led to a doubling in the number of hospitals performing CA as well as state-monitoring of minority outreach and access activities for CA services at each hospital. This proposal builds on AHRQ-funded pilot studies to examine the effectiveness of this innovative policy. Specific aims are to: (1) determine whether the disparity between black and white CA utilization declined following implementation of NJ policies intended to expand access for minority patients, (2) evaluate how local health system characteristics may influence CA disparities and the pathways through which the NJ policy may have reduced these disparities; and (3) identify promising strategies for reducing CA disparities. Hispanic-white CA disparities will also be investigated. Quantitative modeling and qualitative analyses will be blended to evaluate CA disparity trends from 1993-2003 in contrast to trends in a non-reform state. Primary outcome measures are the white-black difference in age-sex adjusted CA rates in small areas and the volume and share of CA utilization by black patients at NJ hospitals that provided CA throughout the study period. Regression methods will be used to adjust for market area demographics and other factors. Hypotheses about the effects of changes in CA capacity and hospital competition will be tested. CA facilities that demonstrate higher-than-expected levels of service to black patients, based on regression models, will be selected for intensive case studies along with a set of matched comparison facilities that are not high performing. The case studies will be focused on the market areas of the selected facilities, and will include documentary review and semi-structured interviews of officials from the selected CA facilities, referring hospitals, community health centers and other players in the case markets. Research findings will be translated to the practice and policy community in the form of "best practices" and through feedback of hospital-specific CA disparity performance measures.
描述(由申请人提供):从1996年开始,新泽西州进行了医院监管改革,这些改革还解决了使用心脏血管造影(CA)的种族和种族差异的长期问题。这些改革导致表演CA的医院数量增加了一倍,以及对每家医院的CA服务的少数民族外展和访问活动的州监控。该提案以AHRQ资助的试点研究为基础,以研究这种创新政策的有效性。具体目的是:(1)确定在实施旨在扩大少数族裔患者访问权限的NJ政策后,黑人和白色CA利用率之间的差异是否下降,(2)评估当地卫生系统特征如何影响CA差异以及NJ政策可能降低这些差异的途径; (3)确定有望减少CA差异的有希望的策略。西班牙裔白人CA差异也将进行调查。与非改革状态的趋势相反,定量建模和定性分析将被混合在一起,以评估1993 - 2003年的CA差异趋势。主要结果指标是小面积年龄 - 性别调整后的CA率的白色差异以及在整个研究期间提供CA的NJ医院黑人患者的数量和CA利用率。回归方法将用于调整市场领域的人口统计和其他因素。将测试有关CA容量和医院竞争变化影响的假设。基于回归模型,将为黑人患者提供高于预期的黑人患者服务水平的CA设施以及一组匹配的比较设施,而表现不高。案例研究将集中在选定设施的市场领域,并包括对所选CA设施的官员的文献审查和半结构化访谈,推荐医院,社区保健中心和案例市场中的其他参与者。研究发现将以“最佳实践”的形式转化为实践和政策界,并通过医院特定的CA差异绩效指标的反馈。

项目成果

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JOEL C CANTOR其他文献

JOEL C CANTOR的其他文献

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{{ truncateString('JOEL C CANTOR', 18)}}的其他基金

The Role of Homelessness and Supportive Housing in Healthcare Disparities among Adults in Medicaid
无家可归和支持性住房在医疗补助成年人医疗保健差异中的作用
  • 批准号:
    10576952
  • 财政年份:
    2021
  • 资助金额:
    $ 23.17万
  • 项目类别:
The Role of Homelessness and Supportive Housing in Healthcare Disparities among Adults in Medicaid
无家可归和支持性住房在医疗补助成年人医疗保健差异中的作用
  • 批准号:
    10408776
  • 财政年份:
    2021
  • 资助金额:
    $ 23.17万
  • 项目类别:
The Role of Homelessness and Supportive Housing in Healthcare Disparities among Adults in Medicaid
无家可归和支持性住房在医疗补助成年人医疗保健差异中的作用
  • 批准号:
    10206880
  • 财政年份:
    2021
  • 资助金额:
    $ 23.17万
  • 项目类别:
Infrastucture for CER on Innovative Delivery Systems for Complex Patients
针对复杂患者的创新输送系统的 CER 基础设施
  • 批准号:
    8020258
  • 财政年份:
    2010
  • 资助金额:
    $ 23.17万
  • 项目类别:
Regulatory Reform and Angiography Disparties
监管改革与血管造影的分歧
  • 批准号:
    6762648
  • 财政年份:
    2004
  • 资助金额:
    $ 23.17万
  • 项目类别:
Regulatory Reforn and Angiography Disparties
监管改革和血管造影的分歧
  • 批准号:
    7113197
  • 财政年份:
    2004
  • 资助金额:
    $ 23.17万
  • 项目类别:

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