Partnerships Between Medicaid, Tumor Registries & Cancer Control Researchers

医疗补助、肿瘤登记处之间的合作伙伴关系

• 批准号: 8531893
• 负责人: Deborah Schrag
• 金额: $ 11.8万
• 依托单位: DANA-FARBER CANCER INST
• 依托单位国家: 美国
• 财政年份: 2012
• 资助国家: 美国
• 起止时间: 2012-08-16 至 2017-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8531893
• 关键词: 21 year old; Academia; Adjuvant; Age; Agreement; American; California; Cancer Center; Cancer Control; Cancer Etiology; Cancer Patient; Caring; Charge; Childhood; Chronic; Chronic Care; Collaborations; Complex; Data; Data Linkages; Data Sources; Diagnosis; Educational process of instructing; Effectiveness; Employment; Enrollment; Environment; Ethnic Origin; Excess Mortality; Eye; Faculty; Feedback; Fostering; Government; Health; Health Care Reform; Health Insurance; Health Personnel; Health Services; Health Services Research; Healthcare; Healthcare Systems; Hormonal; Hormone Receptor; Hospitals; Indigent Care; Institution; Insurance; Insurance Carriers; Insurance Coverage; Intervention; Intervention Studies; Leadership; Life; Malignant Neoplasms; Measures; Medicaid; Medical Oncologist; Medical Records; Medicare/Medicaid; Medicine; Mentors; Mentorship; Minority Groups; Modeling; Nature; New York; Outcome; Palliative Care; Patients; Persons; Pharmacoepidemiology; Physicians; Population; Poverty; Provider; Public Health; Public Health Schools; Publications; Quality of Care; Race; Research; Research Infrastructure; Research Methodology; Research Personnel; Research Project Grants; Resources; Senior Scientist Award; Social Class; Solid Neoplasm; Solutions; Staging; State Children' s Health Insurance Program; Students; Surveys; System; Testing; Training; Translating; Treatment outcome; Update; Woman; Work; base; beneficiary; cancer care; cancer therapy; cancer type; care delivery; career; career development; chemotherapy; design; disability; follow-up; genetic linkage analysis; health disparity; hormone therapy; improved; innovation; malignant breast neoplasm; medical schools; member; mortality; neoplasm registry; next generation; population health; professor; programs; racial and ethnic disparities; skills; therapy design; tool; tumor registry

DESCRIPTION (provided by applicant): This K05 proposal will support Dr. Schrag's efforts to train the next generation of health services researchers in cancer control and establish partnerships with state public health departments that leverage information from linkages between tumor registry, Medicaid and Medicare data. She will augment established linkages between these data sources in New York and California to evaluate quality and effectiveness of cancer care, identify priorities for intervention studies and pilot test feedback systems. Candidate Qualifications: Dr. Schrag is a medical oncologist and health services researcher and an Associate Professor of Medicine at Harvard Medical School. She also has an MPH from the Harvard School of Public Health. She has an accomplished research record, a current R01 directly relevant to the proposed work, and a successful teaching and mentorship track record. Career Development: Dr. Schrag seeks to enhance her already well developed health services research methods expertise through focused coursework in geospatial analysis and advanced pharmacoepidemiology. She seeks to cultivate her leadership skills to foster partnerships with state health departments and pursue externships to solidify these collaborations. Mentorship Objectives: Dr. Schrag proposes to dedicate 25% effort to mentorship and 10% to a complementary set of research projects that focus on care delivery for Medicaid insured cancer patients. She will train pre/postdoctoral students at Harvard, at neighboring institutions and in the New York State health department in health services research methods and quality improvement. Career Objectives: * To decrease the magnitude of disparities based on race and class by focusing on cancer care delivery for persons enrolled in Medicaid programs, the primary health insurer for Americans living in poverty. * To evaluate the effectiveness of new cancer treatments as they are used by patients living with challenges created by poverty and/or chronic disability. * To develop intervention strategies that improve cancer treatment for patients who have the largest gaps between actual and attainable treatment outcomes. * To develop sustainable strategic partnerships between providers (hospitals and physicians), researchers and health departments responsible for oversight of public insurance programs and population health. Research Project Objectives: Innovative, High Impact and Well Integrated with Mentorship Plans 1. Expand Capacity for Tumor Registry-Medicaid-Medicare Data Linkages to Evaluate Cancer Care * Update the NY and CA data linkages to include more recent cases with longer follow-up * Extend the NYS data linkages to include the pediatric population * Measure agreement between medical records and Medicaid administrative data * Develop tools that facilitate use of Medicaid data linkages by other investigators 2. Evaluate the Quality and Effectiveness of Care for Medicaid Recipients with Cancer * Evaluate use and outcomes of hormonal and chemotherapy for early stage breast cancer * Evaluate palliative care for patients with advanced solid tumors 3. Identify Specific Mechanisms that Explain Shortcomings and Design Interventions to Improve Care * Survey Medicaid enrollees about reasons for their underuse of care with known efficacy * Provide health care providers with data about care delivery for their Medicaid patients * Pilot capacity of feedback loops between NYS Medicaid, its enrollees and providers to improve care Environment: Dana-Farber/Harvard: The collaborative research program of the Dana-Farber/Harvard Cancer Center brings together seven institutions including the Harvard Schools of Medicine and Public Health. Dr. Schrag and her mentees have access to the wealth of resources at these institutions, including computing, space, training, cores, and expert research faculty. Research will be carried out in close collaboration with the New York State Department of Health's (NYSDOH) Cancer Registry and Medicaid leadership. The DFCI-NYSDOH partnership will take place via regular calls, webinars and trips to Albany, NY. Innovation and Impact: This work is innovative because it will develop an important but underutilized resource, train users and build its capacity as a launching pad for quality improvement. The proposed work is high impact because it will prioritize problems, identify solutions, and create sustainable infrastructure to improve care in NY, CA. This model can be adapted by other states invested in population health.

描述（由申请人提供）：该K05提案将支持Schrag博士在癌症控制中培训下一代卫生服务研究人员的努力，并与州公共卫生部门建立合作伙伴关系，这些伙伴关系利用肿瘤注册表，医疗补助和医疗保险数据之间的联系来利用信息。她将在纽约和加利福尼亚州的这些数据源之间建立联系，以评估癌症护理的质量和有效性，确定干预研究的优先级和试点测试反馈系统。 候选人资格：Schrag博士是一名医学肿瘤学家和卫生服务研究员，也是哈佛医学院的医学副教授。她还拥有哈佛大学公共卫生学院的MPH。她拥有丰富的研究记录，当前的R01与拟议的工作直接相关，并且是成功的教学和指导记录。 职业发展：Schrag博士旨在通过重点在地理空间分析和高级药物电子学方面的重点课程来增强她已经发达的卫生服务研究方法专业知识。她试图培养自己的领导能力，以促进与州卫生部门建立伙伴关系，并追求实践以巩固这些合作。 指导目标：Schrag博士建议将25％的努力用于指导，而10％的互补研究项目集中在医疗补助保险癌症患者的护理上。她将在哈佛大学，邻近机构和纽约州卫生部门的卫生服务研究方法和质量改进的培训前/博士后学生培训。 职业目标： *通过专注于参加Medicaid计划的人的癌症护理分娩，以减少基于种族和阶级的差异，这是贫困中的美国人的主要健康保险公司。 *评估新的癌症治疗的有效性，因为他们被贫困和/或慢性残疾造成的挑战的患者使用。 *制定干预策略，以改善实际和可达到治疗结果之间差距最大的患者的癌症治疗。 *为了在提供者（医院和医师）之间建立可持续的战略伙伴关系，研究人员和卫生部门负责监督公共保险计划和人口健康。 研究项目目标：创新，高影响力和与指导计划良好的融合 1。扩大肿瘤注册人中事 - 医疗数据链接以评估癌症护理的能力 *将纽约和CA数据链接更新以包括更近的案例，随访时间更长 *将NYS数据链接扩展到包括小儿种群 *衡量医疗记录和医疗补助行政数据之间的协议 *开发工具，促进其他研究人员使用医疗补助数据链接 2。评估癌症医疗补助接受者护理的质量和有效性 *评估早期乳腺癌的荷尔蒙和化学疗法的使用和结果 *评估晚期实体瘤患者的姑息治疗 3.确定特定机制来解释缺点和设计干预措施以改善护理 *调查医疗补助招待会关于他们不足以接受已知疗效的护理原因 *向医疗保健提供者提供有关其医疗补助患者护理服务的数据 * NYS Medicaid，其参与者和提供者改善护理的反馈回路的试点能力 环境：Dana-Farber/Harvard：Dana-Farber/Harvard Cancer Center的合作研究计划汇集了包括哈佛医学和公共卫生学校在内的七个机构。 Schrag博士和她的受训者可以在这些机构中获得丰富的资源，包括计算，空间，培训，核心和专家研究学院。研究将与纽约州卫生部（NYSDOH）的癌症注册表和医疗补助领导层密切合作。 DFCI-Nysdoh合作伙伴关系将通过常规电话，网络研讨会和纽约州奥尔巴尼的旅行进行。 创新和影响：这项工作具有创新性，因为它将开发出一种重要但未充分利用的资源，培训用户并建立其能力作为质量改进的发射垫。拟议的工作是很大的影响，因为它将优先考虑问题，确定解决方案并创建可持续的基础设施以改善加利福尼亚州纽约州的护理。该模型可以由投资人口健康的其他州进行调整。