Prognostic Significance of Insufficient ADL Help on Health Outcomes/Utilization

ADL 帮助不足对健康结果/利用率的预后意义

• 批准号: 8437181
• 负责人: LAURA P. SANDS
• 金额: $ 14.07万
• 依托单位: PURDUE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2010
• 资助国家: 美国
• 起止时间: 2010-04-01 至 2016-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8437181
• 关键词: Activities of Daily Living; Acute; Admission activity; Age; Aging; Bathing; Behavioral Model; Caring; Cessation of life; Clinical; Community Surveys; Complement; Cross-Sectional Studies; Data; Data Analyses; Dementia; Disabled Persons; Eating; Elderly; Event; Expenditure; Future; Gender; Goals; Health; Health Resources; Health Services; Health Status; Healthcare; Hospitalization; Hospitals; Individual; Institutes; Link; Long-Term Care; Longitudinal Studies; Measures; Medicare; Medicare claim; Methods; Needs Assessment; Nursing Homes; Outcome; Patient Self-Report; Patients; Pattern; Persons; Policy Maker; Population; Public Health; Reporting; Research; Research Personnel; Resources; Risk; Sterile coverings; Surveys; Time; Variant; Vital Statistics; base; clinically significant; design; disability; health care service utilization; high risk; mortality; patient oriented; population based; prevent; prognostic; public health relevance; racial and ethnic; response; social

DESCRIPTION (provided by applicant): Approximately 20% of older adults report they do not have sufficient care for their activity of daily living (ADL) disabilities. Prior research suggests that subjective assessments of insufficient care are associated with negative health events such as hospitalization, nursing home placement, and mortality. However, it is not known whether subjective assessments provide prognostic information about health outcomes and health care utilization that is not already provided by traditionally measured demographic, resource, health, and functional risks for these outcomes. The specific aims of our proposal are to determine: (1) the unique prognostic significance of subjective assessments of insufficient ADL care on health outcomes and health care utilization; (2) whether there are age, gender and racial/ethnic variations in the prognostic significance of subjective assessments of insufficient ADL care for subsequent health outcomes and health care utilization, and (3) the extent to which type and amount of ADL care received explains the association between subjective assessments of insufficient personal ADL and subsequent health outcomes and utilization. We will conduct this study using data from 5,995 ADL disabled individuals from the 1994, 1999, and 2004 National Long Term Care Survey community assessments. Health outcomes and health care utilization patterns will be determined from linked Medicare claims and vital statistics data. The National Long Term Care Survey is a population-based survey with extensive self-reported information about ADL functioning, help received, health status, and resources for obtaining health care. The results will inform whether subjective assessments of insufficient ADL help complement traditional assessments of need currently used by clinicians, policy makers, and researchers. The results will also inform the public health significance of subjective assessments of insufficient ADL care by assessing whether they are independently associated with excess health burden in a population that is already at high risk for poor health outcomes and high health care utilization.

描述（由申请人提供）：大约 20% 的老年人表示，他们的日常生活活动 (ADL) 障碍没有得到足够的照顾。先前的研究表明，对护理不足的主观评估与住院、疗养院安置和死亡率等负面健康事件有关。然而，尚不清楚主观评估是否提供了有关健康结果和医疗保健利用的预后信息，而传统测量的人口、资源、健康和功能风险尚未提供这些信息。我们提案的具体目标是确定：（1）ADL 护理不足的主观评估对健康结果和医疗保健利用的独特预后意义； (2) ADL 护理不足对后续健康结果和医疗保健利用的主观评估的预后意义是否存在年龄、性别和种族/民族差异，以及 (3) 接受的 ADL 护理类型和数量在多大程度上解释了个人日常生活活动不足的主观评估与随后的健康结果和利用之间的关联。我们将使用来自 1994 年、1999 年和 2004 年国家长期护理调查社区评估的 5,995 名 ADL 残疾人的数据来进行这项研究。健康结果和医疗保健利用模式将根据链接的医疗保险索赔和生命统计数据确定。国家长期护理调查是一项以人口为基础的调查，提供有关 ADL 功能、接受的帮助、健康状况以及获得医疗保健的资源的广泛自我报告信息。结果将表明对日常生活能力不足的主观评估是否有助于补充临床医生、政策制定者和研究人员目前使用的传统需求评估。研究结果还将通过评估ADL护理不足的主观评估是否与已经处于健康结果不良和高医疗保健利用率高风险的人群中的过度健康负担独立相关，为公共卫生意义提供信息。

项目成果

Unmet Need for Help With Activities of Daily Living Disabilities and Emergency Department Admissions Among Older Medicare Recipients.

老年医疗保险受益人日常生活障碍活动和急诊科入院方面的帮助需求未得到满足。

• 发表时间: 2017-04-01
• 作者: Hass, Zach;DePalma, Glen;Craig, Bruce A;Xu, Huiping;Sands, Laura P
• 通讯作者: Sands, Laura P

Volume of home- and community-based services and time to nursing-home placement.

家庭和社区服务量以及疗养院安置时间。

• 发表时间: 2012
• 作者: Sands, Laura P;Xu, Huiping;Thomas 3rd, Joseph;Paul, Sudeshna;Craig, Bruce A;Rosenman, Marc;Doebbeling, Caroline C;Weiner, Michael
• 通讯作者: Weiner, Michael

Volume of home- and community-based Medicaid waiver services and risk of hospital admissions.

基于家庭和社区的医疗补助豁免服务量以及住院风险。

• 发表时间: 2010-01
• 影响因子: 6.3
• 作者: Xu, Huiping;Weiner, Michael;Paul, Sudeshna;Thomas, Joseph;Craig, Bruce;Rosenman, Marc;Doebbeling, Caroline Carney;Sands, Laura P
• 通讯作者: Sands, Laura P

Unmet Need for ADL Assistance Is Associated With Mortality Among Older Adults With Mild Disability.

日常生活活动援助需求未得到满足与轻度残疾老年人的死亡率有关。

• DOI: 10.1093/gerona/glv028
• 发表时间: 2015-09-01
• 期刊: The journals of gerontology. Series A, Biological sciences and medical sciences
• 作者: Shuang He;B. Craig;Huiping Xu;K. Covinsky;E. Stallard;J. Thomas;Zachary Hass;Laura P. S;s;s
• 通讯作者: s

Insufficient help for activity of daily living disabilities and risk of all-cause hospitalization.

对日常生活活动障碍和全因住院风险的帮助不足。

• 发表时间: 2012-05
• 影响因子: 6.3
• 作者: Xu, Huiping;Covinsky, Kenneth E;Stallard, Eric;Thomas 3rd, Joseph;Sands, Laura P
• 通讯作者: Sands, Laura P