Racial disparities in access to high quality hospitals for coronary heart disease

冠心病就诊优质医院的种族差异

• 批准号: 8523958
• 负责人: Ioana Popescu
• 金额: $ 12.71万
• 依托单位: UNIVERSITY OF CALIFORNIA LOS ANGELES
• 依托单位国家: 美国
• 财政年份: 2009
• 资助国家: 美国
• 起止时间: 2009-07-15 至 2014-09-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8523958
• 关键词: Accident and Emergency department; Accounting; Acute myocardial infarction; Adherence; Admission activity; Affect; Ambulatory Care; American Hospital Association; American Medical Association; Area; Assimilations; Attention; Award; Bypass; Cardiovascular Diseases; Cardiovascular system; Caring; Censuses; Characteristics; Clinical; Clinical Research; Code; Comorbidity; Complex; Coronary Artery Bypass; Coronary heart disease; Data; Data Sources; Databases; Decision Making; Demographic Accounting; Distant; Education; Funding; Geographic Factor; Geographic Information Systems; Geography; Goals; Guideline Adherence; Guidelines; Healthcare; Healthcare Market; Healthcare Systems; Heart Diseases; Hospitals; Housing; Individual; Inpatients; Instruction; Internal Medicine; Lead; Marketing; Measurable; Measures; Medicare; Mentors; Methods; Modeling; Myocardial Ischemia; Outpatients; Patient Preferences; Patients; Pattern; Physicians; Plant Roots; Play; Primary Health Care; Principal Investigator; Race; Reading; Research; Research Ethics; Research Personnel; Rights; Role; Series; Services; Severity of illness; Social Environment; Socioeconomic Status; Sociology; Source; Surveys; System; Techniques; Time; Training; Travel; Variant; Work; base; career; career development; cohort; design; experience; high risk; percutaneous coronary intervention; research and development; residence; segregation; skills; socioeconomics

The primary goal of this K08 application is to support Dr loana Popescu to become an independent investigator in the area of racial disparities in cardiovascular disease. The application will involve the assimilation of new methodological skills and the analysis of a number of existing health care databases. In support of the application, Dr. Popescu has assembled a team of experienced mentors-Drs. Gary Rosenthal (Department of Internal Medicine), Gerald Rushton (Geography), and Kevin Leicht (Sociology), who bring expertise in complementary methodological areas and who have assisted Dr. Popescu in designing integrated plans for career development and research. The Career Plan includes advanced training in: 1) hierarchical biostatistical modeling and clinical research ethics; 2) the application of spatial analysis and geographic information systems methods in health care; and 3) methods for measuring residential segregation and understanding its sociological roots. These goals will be accomplished through targeted coursework, tutorials, directed readings, and direct research experiences guided by her mentors. The Research Plan will examine the interplay between geography, segregation and health care system factors, in order to build a comprehensive understanding of why black patients are less likely to receive care for acute myocardial infarction, percutaneous coronary intervention, and coronary artery bypass surgery in high quality hospitals. The Research Plan includes three incremental aims that capitalize on a number of national data sources, including: Medicare inpatient and outpatient claims files; US Census data; American Hospital Association surveys; the American Medical Association Physician Masterfile; and DartmouthAtlas health care market data. Aim 1 will examine the relationship between race, proximity to the admitting and to high quality hospitals, and the likelihood of admission to high quality hospitals. Aim 2 will evaluate the effects of residential segregation on disparities in admissions to high quality hospitals. Aim 3 will examine the effects of patterns of prior outpatient care on disparities in admission to high quality hospitals and will build Dr. Popescu's fluency in analyzing more complex outpatient physician claims files. RELEVANCE (See instructions): Despite sustained national attention, significant gaps remain in research on causes of racial disparities in cardiovascular disease. The proposed projects will bring an important contribution to elucidating the geographic and social context factors contributing to these persistent disparities.

此 K08 申请的主要目标是支持 Loona Popescu 博士成为独立人士 心血管疾病种族差异领域的研究者。该申请将涉及 吸收新的方法技能并分析一些现有的卫生保健数据库。在 在申请的支持下，Popescu博士组建了一支经验丰富的导师团队——Drs.加里 Rosenthal（内科）、Gerald Rushton（地理学）和 Kevin Leicht（社会学）， 他们带来了互补方法领域的专业知识，并协助波佩斯库博士 设计职业发展和研究的综合计划。 职业规划包括以下方面的高级培训：1) 分层生物统计建模和临床研究 伦理; 2）空间分析和地理信息系统方法在医疗保健中的应用；和 3）测量居住隔离并了解其社会学根源的方法。这些目标将 通过有针对性的课程、教程、定向阅读和直接研究经验来完成 在她的导师的指导下。 该研究计划将研究地理、种族隔离和医疗保健系统之间的相互作用 因素，以便全面了解为什么黑人患者接受护理的可能性较小 用于急性心肌梗死、经皮冠状动脉介入治疗、冠状动脉搭桥手术 高品质医院。该研究计划包括三个增量目标，这些目标利用了许多 国家数据源，包括： 医疗保险住院和门诊索赔文件；美国人口普查数据；美国人 医院协会调查；美国医学会医师主档案；和达特茅斯阿特拉斯 医疗保健市场数据。目标 1 将检查种族、与录取者的接近度和录取结果之间的关系 高质量的医院，以及进入高质量医院的可能性。目标 2 将评估 居住隔离对优质医院入院差异的影响。目标 3 将检查 先前的门诊护理模式对进入高质量医院的差异的影响和意愿 培养 Popescu 博士能够流利地分析更复杂的门诊医生索赔文件。 相关性（参见说明）： 尽管全国持续关注，但对种族差异原因的研究仍然存在重大差距 心血管疾病。拟议的项目将为阐明 地理和社会背景因素导致了这些持续存在的差异。