CAM Use, Costs, Outcomes in Recurrent Back Pain Episodes

复发性背痛发作中 CAM 的使用、成本和结果

• 批准号: 6816749
• 负责人: MONICA M SMITH
• 金额: $ 12.92万
• 依托单位: PALMER COLLEGE OF CHIROPRACTIC
• 依托单位国家: 美国
• 财政年份: 2004
• 资助国家: 美国
• 起止时间: 2004-09-15 至 2009-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6816749
• 关键词: acupuncture /acupressure; alternative medicine; backache; behavioral /social science research tag; chiropractic; clinical research; functional ability; geographic difference; health behavior; health care cost /financing; health care service utilization; health insurance; health services research tag; human data; longitudinal human study; occupations; outcomes research; physicians; quality of life; relapse /recurrence; rural area; socioeconomics

DESCRIPTION (provided by applicant): Immediate and Ionq-term career goals: Immediate goals are: 1) develop knowledge and research skills necessary to study the economic, sociological, psychological, and clinical determinants and outcomes of utilization of CAM services; 2) determine the relationship between the utilization of chiropractic and acupuncture services, and utilization of other health care services, for episodic recurrent back pain; 3) estimate effect of chiropractic/acupuncture utilization on costs of care, disability, and quality of life for episodic recurrent back pain; and 4) refine methods to construct clinically relevant episodes-of-care for recurrent back pain, from administrative claims data. Long-term goals are to 1) apply this knowledge to test hypotheses about inter-relationships between utilization of various CAM services, utilization of other health services, the costs, quality, outcomes, disability and disability costs, for various health conditions; 2) meaningfully contribute to our understanding of long-term conditions characterized by episodic acute recurrences; 3) contribute to developing comprehensive, multidisciplinary, and scientifically rigorous approaches to research significant clinical and public health questions; and 4) contribute to improving the quality of the research literature to better inform consumer, clinical, and health policy decision-making. Research career development plan: The plan includes: 1) didactic training in the science and methods of health services research and policy, with focused training in health economics and econometric modeling; 2) supervised secondary analysis of public-use national survey data to model the relationships between chiropractic and acupuncture utilization, other health services utilization, costs of care, disability, and quality of life, for episodic recurrent back pain; 3) supervised secondary analysis of administrative claims data to refine methods for constructing clinically relevant episodes-of-care for episodic recurrent back pain; and 4) development of independent investigator-initiated grant proposals. Research project: The proposed project will use 2-year longitudinal data from the Medical Expenditures Panel Survey (MEPS) to describe the patterns of utilization of chiropractic, acupuncture, and other health services for episodic recurrent back pain, and to estimate the influence of economic and sociological determinants on that utilization. This study will advance knowledge by identifying predetermining factors for CAM utilization, and will enhance our understanding of contextual and behavioral factors related to episodic recurrent conditions. Findings from these analyses, with the results of studies estimating the effects of CAM utilization on costs of care, disability, and quality of life, will be used to design follow-up projects to study interrelationships between economic, psychosocial, and clinical determinants and outcomes of CAM use.

描述（由申请人提供）： 近期和长期职业目标： 近期目标是： 1) 培养研究经济、社会学、心理和临床决定因素以及 CAM 服务利用结果所需的知识和研究技能； 2) 针对阵发性复发性背痛，确定脊椎按摩疗法和针灸服务的利用与其他医疗保健服务的利用之间的关系； 3) 评估脊椎按摩疗法/针灸疗法对阵发性复发性背痛的护理费用、残疾和生活质量的影响； 4) 根据行政索赔数据，完善方法来构建针对复发性背痛的临床相关护理事件。长期目标是 1) 应用这些知识来测试关于不同健康状况的各种 CAM 服务的利用、其他卫生服务的利用、成本、质量、结果、残疾和残疾费用之间相互关系的假设； 2）有意义地有助于我们理解以偶发性急性复发为特征的长期疾病； 3) 致力于开发全面的、多学科的、科学严谨的方法来研究重大的临床和公共卫生问题； 4) 有助于提高研究文献的质量，以便更好地为消费者、临床和健康政策决策提供信息。 研究职业发展计划：该计划包括：1）卫生服务研究和政策的科学和方法方面的教学培训，重点是卫生经济学和计量经济建模方面的培训； 2) 对公共使用的全国调查数据进行监督二次分析，以模拟脊椎按摩疗法和针灸疗法的利用、其他卫生服务的利用、护理费用、残疾和生活质量之间的关系，以治疗阵发性复发性背痛； 3) 对行政索赔数据进行监督二次分析，以完善构建针对阵发性复发性背痛的临床相关护理事件的方法； 4) 制定独立研究者发起的资助提案。 研究项目：拟议项目将使用医疗支出的 2 年纵向数据 小组调查 (MEPS) 描述脊椎按摩疗法、针灸和其他卫生服务用于治疗阵发性复发性背痛的模式，并估计经济和社会学决定因素对这种利用的影响。这项研究将通过确定 CAM 使用的预定因素来增进知识，并将增强我们对与阵发性复发性疾病相关的背景和行为因素的理解。这些分析的结果以及估计 CAM 使用对护理成本、残疾和生活质量影响的研究结果将用于设计后续项目，以研究经济、社会心理和临床决定因素与结果之间的相互关系CAM 的使用。