Mobile Telecare for Underserved African-American Elders with Heart Failure

为服务不足的患有心力衰竭的非洲裔美国老年人提供移动远程护理

基本信息

批准号：
8549599
负责人：
Hongtu Chen
金额：
$ 19.95万
依托单位：
ENVIRONMENT AND HEALTH GROUP, INC.
依托单位国家：
美国
项目类别：
财政年份：
2013
资助国家：
美国
起止时间：
2013-09-25 至 2015-03-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/8549599
关键词：
Accident and Emergency department Acute Adherence Affect African American Attitude Car Phone Cardiac Caring Case Management Chronic Clinical Clinical Trials Collaborations Communication Communities Community Hospitals Computer software Congresses Data Devices Diagnosis Effectiveness Elderly Evaluation Family Foundations Goals Health Health Personnel Health Professional Heart Heart failure High Prevalence Hospitalization Hospitals Individual Institutes Intervention Lead Length of Stay Managed Care Medicaid Medical Medicare Medicare/Medicaid Modeling Outcome Participant Patients Phase Physicians Population Prevalence Preventive Protocols documentation Provider Qualifying Quality of Care Quality of life Randomized Clinical Trials Randomized Controlled Trials Recommendation Reporting Resources Risk Sample Size Self Care Services Small Business Innovation Research Grant Solutions South Carolina Specialist System Target Populations Technology Testing Time United States United States Centers for Medicare and Medicaid Services Visit Vulnerable Populations base beneficiary care seeking collaborative care community based care comparison group cost cost effective cost effectiveness design dual eligible experience follow-up health disparity health literacy high risk hospital readmission improved innovation intervention program medical specialties payment phase 1 study phase 2 study preference prevent programs public health relevance randomized trial skills software development successful intervention telecare treatment as usual

项目摘要

Title: Mobile Telecare for Underserved African-American Elders with Heart Failure Abstract Older adults who are dually eligible for Medicare and Medicaid are among the sickest and poorest individuals covered in either program. Although they have a significantly higher prevalence of chronic conditions, such as heart failure (HF) than all other Medicare beneficiaries, as few as 2% of dual eligible patients receive the type of case management or care coordination that can prevent hospitalizations and emergency department visits for acute medical problems. African-Americans are particularly at risk, having the highest rates of HF-related hospitalizations compared to all other Medicare beneficiaries. In this Phase I SBIR, we will conduct a pilot clinical trial to test a care coordination program designed for African-American dual eligible older adults with HF who have been discharged from a regional hospital and who are being cared for by community-based health care providers. The proposed Mobile Heart Care Coordination (MHCC) program integrates telemonitoring through a Bluetooth-enabled device and mobile phone-based communication technologies that connect hospital-based cardiac care teams with community-based providers. The goal of the program is to provide coordinated post-discharge care in order to reduce potentially-avoidable hospitalizations and emergency room visits. This Phase I SBIR will develop and test the MHCC intervention's feasibility and short-term outcomes for dual eligible African-Americans with HF. In a Phase II application, we will conduct a randomized clinical trial with African-American dual-eligible older adults with HF to determine whether participants in the MHCC- enhanced program are less likely to be readmitted within 30 days of hospital discharge (primary hypothesis) and less likely to access emergency room care (secondary hypothesis) compared to the comparison group (usual care). The Phase I application will provide the necessary data to determine the sample size required for the larger adequately powered randomized controlled trial in Phase II. The subsequent Phase II application will result in an innovative, cost-effective, and nationally replicable care coordination model aimed at reducing potentially-avoidable hospitalizations and emergency room visits, and improving quality of care for all African- American dual eligible patients with HF.

标题：为患有心力衰竭的服务不足的非洲裔美国老年人提供移动远程护理抽象的具有医疗保险和医疗补助双重资格的老年人是病情最严重和最贫困的人之一任一计划均涵盖。尽管他们的慢性病患病率明显更高，例如心力衰竭 (HF) 高于所有其他 Medicare 受益人，只有 2% 的双重资格患者接受该类型可以防止住院和急诊就诊的病例管理或护理协调对于急性医疗问题。非洲裔美国人面临的风险尤其大，心衰相关发病率最高与所有其他医疗保险受益人相比，住院率更高。在第一阶段 SBIR 中，我们将进行试点测试专为非裔美国双重资格患有心力衰竭的老年人设计的护理协调计划的临床试验已从地区医院出院并正在接受社区卫生部门护理的人护理提供者。拟议的移动心脏护理协调 (MHCC) 计划集成了远程监控通过支持蓝牙的设备和基于移动电话的通信技术进行连接医院心脏护理团队与社区提供者。该计划的目标是提供协调出院后护理，以减少本来可以避免的住院和急诊室治疗访问。第一阶段 SBIR 将开发和测试 MHCC 干预措施的可行性和短期结果具有双重资格的心力衰竭非裔美国人。在II期申请中，我们将进行随机临床试验与患有 HF 的非洲裔美国双重资格老年人一起确定 MHCC 的参与者是否强化计划在出院后 30 天内重新入院的可能性较小（主要假设）与对照组相比，获得急诊室护理的可能性较小（次要假设）（日常护理）。第一阶段申请将提供必要的数据来确定所需的样本量 II 期规模更大、动力充足的随机对照试验。后续二期申请将产生创新的、具有成本效益的、全国可复制的护理协调模式，旨在减少可能避免的住院治疗和急诊室就诊，并提高所有非洲人的护理质量美国双重资格的心力衰竭患者。