Improving Access to and Quality of Eye Care in an At-Risk, Underserved Population

改善高危、服务不足的人群获得眼科护理的机会和质量

• 批准号: 8690570
• 负责人: CYNTHIA OWSLEY
• 金额: $ 25万
• 依托单位: UNIVERSITY OF ALABAMA AT BIRMINGHAM
• 依托单位国家: 美国
• 财政年份: 2010
• 资助国家: 美国
• 起止时间: 2010-09-30 至 2016-09-29
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8690570
• 关键词: Improving; Access; Quality; Eye; Care

DESCRIPTION (provided by applicant): The focus of our TRC network center is on a high-risk yet underserved segment of the e 40 years old population, namely African Americans residing in Jefferson County, Alabama, many of who are uninsured. Rates of vision impairment and eye disease among African Americans are two times higher than those of older whites, especially glaucoma and diabetic retinopathy. The public health challenge is that if these eye problems had been detected early, much of this disease and vision impairment would be reversible and preventable with currently available ophthalmic treatments. Previous research has suggested that African Americans adults are less likely to receive routine, comprehensive eye care, when newly emerging eye conditions could be detected and treated in a timely fashion. The personal burden of eye disease and vision impairment is heavy. Vision impairment causes difficulties in maintaining a high quality of life and hampers reading, mobility, financial management, and engagement in social activities. Persons with vision impairment are at increased risk for depression, transportation challenges, being unemployed, placement into long-term care, injury, and mortality. As a society, the economic burden of vision impairment is staggering. The annual cost of adult vision problems in the U.S. has been estimated to be about $51.4 billion. Many barriers to care likely underlie the exacerbated vision impairment rates in African Americans, including cost, lack of health insurance, communication, trust, and their having an inadequate understanding of how eye diseases can be prevented. Characteristics of the healthcare system itself undoubtedly contribute, such as a shortage of eye care providers who work in geographic areas with high-risk populations, a shortage of clinics that accept patients who are uninsured, insufficient funds to staff these clinics, and associated challenges in following preferred practice patterns to improving outcomes. We have a unique resource here in Alabama to address these pressing issues, through a partnership between the University of Alabama at Birmingham (UAB) and the Cooper Green Hospital/Jefferson Health System (CGH/JHS). CGH/JHS serves all residents of Jefferson County regardless of their ability to pay. About 80% percent of adult patients seen at the CHS/JHS clinics are African American and about 70% have no health insurance whatsoever. Over 60% have been diagnosed with glaucoma or have diabetes or both. Using the CGH/JHS administrative database and our ability to study individual patients in the clinics, our research center will provide information on how to improve access to and the quality of eye care for this underserved population. Studies will focus on primary open angle glaucoma, diabetic eye care, and visually impaired persons in need of rehabilitation services. Our center will also participate in TRC network-wide studies to be designed collaboratively with the other network centers and CDC.

描述（由申请人提供）：我们的TRC网络中心的重点是40岁人口的高风险但服务不足的部分，即居住在阿拉巴马州杰斐逊县的非裔美国人，其中许多没有保险。非洲裔美国人的视力障碍和眼病的发生率是较老的白人的两倍，尤其是青光眼和糖尿病性视网膜病。公共卫生挑战是，如果早期发现这些眼睛问题，这种疾病和视力障碍的大部分将是可逆的，并且可预防目前可用的眼科治疗方法。先前的研究表明，当可以及时检测和治疗新兴的眼睛状况时，非洲裔美国人的成年人不太可能接受常规，全面的眼保健。眼病和视力障碍的个人负担很大。视力障碍在维持高质量的生活和障碍物阅读，流动性，财务管理和参与社交活动方面造成了困难。视力障碍的人有抑郁症，运输挑战，失业，置于长期护理，伤害和死亡率的风险增加。作为一个社会，视力障碍的经济负担令人震惊。美国成人视力问题的年度成本估计约为514亿美元。许多护理的障碍可能是非洲裔美国人加剧的视力障碍率的基础，包括成本，缺乏健康保险，沟通，信任以及他们对如何预防眼部疾病的了解不足。医疗保健系统本身的特征无疑会做出贡献，例如，在高风险人群的地理区域工作的眼保健提供者短缺，接受未投保的患者的诊所的短缺，向员工提供资金不足的诊所以及与这些诊所的相关挑战，以遵循以下优先实践模式来改善型号。我们在阿拉巴马州拥有独特的资源，可以通过阿拉巴马大学伯明翰大学（UAB）与库珀绿医院/杰斐逊卫生系统（CGH/JHS）之间的合作关系解决这些紧迫问题。 CGH/JHS为杰斐逊县的所有居民提供服务，无论其付款能力如何。在CHS/JHS诊所看到的成年患者中，约有80％的患者是非裔美国人，约有70％的患者没有任何健康保险。超过60％的人被诊断出患有青光眼或糖尿病或两者兼而有之。使用CGH/JHS行政数据库以及我们在诊所研究个别患者的能力，我们的研究中心将提供有关如何改善该服务不足人群的获得眼部护理质量的信息。研究将重点放在主要的开头青光眼，糖尿病眼保健和需要康复服务的视力障碍者。我们的中心还将参与TRC网络范围内的研究，以与其他网络中心和CDC合作设计。