The Silver Tsunami: Projecting multimorbidity, polypharmacy,and healthcare costs for those aging with HIV in the US

银色海啸：预测美国艾滋病毒感染者的多重发病率、多药治疗和医疗保健费用

• 批准号: 9137799
• 负责人: Keri Nicole Althoff
• 金额: $ 54.87万
• 依托单位: JOHNS HOPKINS UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2016
• 资助国家: 美国
• 起止时间: 2016-09-30 至 2021-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9137799
• 关键词: AIDS prevention; AIDS/HIV problem; Accounting; Achievement; Acquired Immunodeficiency Syndrome; Adult; Affect; Age; Age Distribution; Aged, 80 and over; Aging; American; Awareness; Baby Booms; Budgets; Cardiovascular system; Caring; Characteristics; Chronic Kidney Failure; Clinical Management; Collaborations; Comorbidity; Cost Savings; Cost of Illness; Data; Databases; Disease; Elderly; End stage renal failure; Environment; Epidemiology; Funding; General Population; Geography; Goals; Guidelines; HIV; HIV Infections; Health Care Costs; Health Services; Health Services Accessibility; Health system; Health system plans; Healthcare; Healthcare Systems; Individual; Insulin Resistance; Intervention; Investigation; Knowledge; Life; Life Expectancy; Malignant Neoplasms; Mentored Research Scientist Development Award; Metabolic; Methods; Modeling; Myocardial Infarction; Neurologic; Persons; Pharmaceutical Preparations; Policies; Polypharmacy; Population; Principal Investigator; Productivity; Public Health; Race; Research; Research Design; Research Priority; Resource Allocation; Risk; Savings; Seasons; Silver; Tsunami; United States; United States National Institutes of Health; age related; co-infection; cohort; cost; cost effectiveness; effective therapy; experience; health care service utilization; human old age (65+); models and simulation; prevent; programs; public health relevance; sex; transmission process

 DESCRIPTION (provided by applicant): Due to effective treatment, persons living with HIV and accessing care (PLWHC) in the United States (US) now have a life expectancy approaching the general population. In the general population, the population bubble caused by the post-WWII Baby Boom has been referred to as the "Silver Tsunami." The goal of this project is to fill a vital gap for a more detailed, data-based projection of the imminent PLWHC Silver Tsunami to better inform allocation of resources in governmental and private healthcare systems and to identify targets for savings. Taking into account factors that affect the age distribution of PLWHC in the US, we will use simulation models to project the age distribution through 2030 to answer the question: "What does the projected age distribution of PLWHC in the US look like?" To be useful, data need to be disaggregated by important demographic (sex and race) and geographical characteristics. HIV infection has been shown to increase the risk of insulin resistance, chronic kidney disease, myocardial infarction, end-stage renal disease, and cancer. Incorporating multimorbidity and polypharmacy into the projected age distribution will answer: "What is the projected burden of multimorbidity and polypharmacy in adults aging with HIV?" Information derived by a careful, data-based analysis that includes the burden of multimorbidity and polypharmacy in PLWHC will have many uses. We propose to focus on the important issue of healthcare costs as it is likely that costs will be compounded in adults aging with HIV as compared to those without HIV. By investigating the question "How much will it cost to care for adults aging with HIV?" health systems and state and federal budgets can begin to prepare for both HIV-related and non-HIV-related costs and identify targets for potential cost savings. We have assembled a world-class collaboration that combines high-quality longitudinal data, epidemiological expertise, the scientific leaders of the North American AIDS Cohort Collaboration on Research and Design (NA-ACCORD), and the leaders in modeling of HIV disease and healthcare costs from the Cost-Effectiveness of Preventing AIDS Complications (CEPAC) team to achieve the following aims: AIM 1: To fill the gap in knowledge by projecting age-specific proportions of PLWHC in the US through 2030, with estimates tailored to important demographic and geographic sub-groups. AIM 2: To project the burden of multimorbidity and polypharmacy among PLWHC in the US through 2030. AIM 3: To project the annual costs of non-HIV-related healthcare for PLWHC in the US through 2030. The proposed aims align well with the research priorities of the 2016 Trans-NIH Plan for HIV-Related Research and the NIH HIV/AIDS Research Priorities and Guidelines for Determining AIDS Funding. Findings will provide key HIV epidemiologic and health services data that are necessary for guiding research priorities, increasing awareness of multimorbidity and polypharmacy in clinical management, and informing health systems resource allocations.

 描述（由适用提供）：由于有效的治疗，在美国（美国）患有艾滋病毒和获得护理（PLWHC）的人（PLWHC）（美国）现在的预期寿命接近一般人群。在一般人群中，第二次世界大战后婴儿繁荣引起的人口泡沫被称为“银海啸”。该项目的目的是填补对迫在眉睫的PLWHC银海啸的更详细的，基于数据的预测，以更好地为政府和私人医疗保健系统中的资源分配，并确定储蓄目标。考虑到影响美国PLWHC年龄分布的因素，我们将使用仿真模型在2030年之前投射年龄分布，以回答以下问题：“美国PLWHC的预计年龄分布在美国是什么样的？”为了有用，需要通过重要的人口统计学（性别和种族）和地理特征来消除数据。 HIV感染已被证明会增加胰岛素抵抗，慢性肾脏疾病，心肌梗塞，终末期肾脏疾病和癌症的风险。将多种病态和多种药物纳入预计的年龄分布将回答：“成人艾滋病毒衰老的多发生和多种药物的预计燃烧是什么？”通过仔细的基于数据的分析得出的信息，其中包括PLWHC中多种多发性和多功能药物的燃烧，将有很多用途。我们建议将重点放在医疗保健费用的重要问题上，因为与没有艾滋病毒的成年人相比，成年人衰老的成年人可能会更加复杂。通过调查一个问题：“照顾成人与艾滋病毒衰老的成年人要花多少钱？”卫生系统以及州和联邦的预算可以开始为与HIV相关和非HIV相关的成本做准备，并确定潜在的成本节省的目标。 We have assembled a world-class collaboration that combines high-quality longitudinal data, epidemiological expertise, the scientific leaders of the North American AIDS Cohort Collaboration on Research and Design (NA-ACCORD), and the leaders in modeling of HIV disease and healthcare costs from the Cost-Effectiveness of Preventing AIDS Complications (CEPAC) team to achieve the following aims: AIM 1: To fill the gap in knowle by projecting截至2030年，美国PLWHC的年龄特异性比例，估计是针对重要的人口统计和地理子组量身定制的。目的2：在美国PLWHC之间燃烧多发性和多功能性的燃烧至2030年。目的3：将美国PLWHC的非HIV与HIV相关医疗保健的年度成本在美国到2030年的年成本。拟议的目的与2016年NIH Trans trans trans trans trans Inde and Aid Aiddities的研究优先级的研究优先级相吻合。调查结果将提供关键的HIV流行病学和卫生服务数据，这些数据对于指导研究重点，提高了对临床管理中多种多发病和多药的认识，并为卫生系统资源分配提供了信息。