Do physicians who specialize in nursing home care provide higher quality care for nursing home residents with Alzheimer's Disease and related dementias?

专门从事疗养院护理的医生是否能为患有阿尔茨海默病和相关痴呆症的疗养院居民提供更高质量的护理？

• 批准号: 10445235
• 负责人: Hye-Young Jung
• 金额: $ 9.02万
• 依托单位: WEILL MEDICAL COLL OF CORNELL UNIV
• 依托单位国家: 美国
• 财政年份: 2018
• 资助国家: 美国
• 起止时间: 2018-08-01 至 2024-04-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10445235
• 关键词: Address; Administrator; Age; Aggressive behavior; Agitation; Alzheimer' s disease diagnosis; Alzheimer' s disease related dementia; Ambulatory Care; Antipsychotic Agents; Award; Behavioral; Behavioral Symptoms; Care given by nurses; Caring; Characteristics; Clinical; Communication; Communities; Complement; Complex; Comprehensive Health Care; Data; Data Analyses; Discipline of Nursing; Disease; Effectiveness; Emergency department visit; Enteral Feeding; Evaluation; Family; Family Caregiver; Fellowship; Funding; Gender; General Population; Geriatrics; Goals; Guidelines; Health Care Costs; Health Services Research; Healthcare; Home Nursing Care; Homes for the Aged; Hospitalization; Hour; Individual; Insurance Claim Review; Interview; Knowledge; Leadership; Life Expectancy; Long-Term Care; Measures; Medical; Medical Staff; Medicare claim; Medicare/Medicaid; Modeling; New York; Nurse Administrator; Nursing Homes; Pain management; Pathway interactions; Patient Care; Patients; Persons; Pharmaceutical Preparations; Physician Executives; Physician' s Role; Physicians; Policies; Prevalence; Process; Process Measure; Psychoses; Qualitative Research; Quality Indicator; Quality of Care; Regression Analysis; Regulation; Research; Research Methodology; Research Personnel; Specialist; Specialty Boards; Structure; Syndrome; Time; Training; base; care costs; clinical care; cost; end of life; experience; hospitalization rates; illness length; improved; medical specialties; nursing care quality; nursing home length of stay; psychiatric symptom; restraint; skills; virtual

Project Summary/Abstract The number of physicians with a high proportion of evaluation and management (E&M) claims for nursing home (NH) patients, often referred to as “SNFists” or “NH specialists,” grew from 1496 in 2007 to 2225 by 2014, representing a 48.2% increase. Despite this increase, virtually nothing is known about the relationship between physician specialization in NH care and the quality of care provided to long-stay NH residents. This is particularly important for residents with Alzheimer's Disease and Related Dementias (ADRD). ADRD billion receiving is a progressive, incurable illness that accounts for $226 in health care spending annually. The majority of costs are incurred among individuals in later stages of the disease long-term care. The average life expectancy 4 to 8 yearsfollowing a diagnosis of ADRD is , although some individuals may survive up to 20 years. 75% of people with ADRD will be admitted to NHs by the age of 80 compared to 4% of the general population. Amongindividuals with ADRD, approximately 70% will die inNHs. Both the long duration of the disease and the reliance on NH care increases the importance of improvements in the quality of care provided to long-stay NH residents with ADRD. Physician involvement is essential to the delivery of long-term care of high quality to residents with ADRD in NHs. Within NHs, physicians are responsible for developing and overseeing comprehensive care planning for residents. Physician specialization in NH care may improve their effectiveness by developing knowledge of NH regulations, drug guidelines, and common behavioral syndromes faced by NH residents with ADRD. Specialization in NH care may also help physicians build long-term relationships with patients and families/caregivers leading to better recognition of the needs of both. The primary objective of this study is to determine if physicians who specialize in NH care provide higher quality care to residents with ADRD. This will be done through both quantitative analyses of claims data and analyses of qualitative data collected through semi-structured interviews of NH leadership. The training that I receive through this award will provided me with knowledge of the clinical care received by ADRD patients as well as training in qualitative research methods that complement the quantitative skills that I already possess. The rich skillset that I develop through this training will allow me to connect the results of qualitative and quantitative research that generates much-needed evidence to inform policies and clinical guidelines to optimize the role of physicians in the care provided to long-stay NH residents with ADRD.

项目摘要/摘要 对护士之家（NH）的评估和管理比例很高的医师人数（E＆M）的数量 患者，通常称为“ snfists”或“ NH专家”，从2007年的1496年增长到2014年的2225年，占48.2％ 增加。尽管有这种增长，但实际上对NH的物理专业化之间的关系几乎一无所知 护理和为长期NH居民提供的护理质量。这对于具有的居民尤其重要 阿尔茨海默氏病和相关痴呆症（ADRD）。 adrd 十亿 接收 是一种进步，无法治愈的疾病，占226美元 每年在医疗保健支出中。在该疾病后期的个人中，大多数成本是在个人中产生的 长期护理。 ADRD诊断后4到8年的平均预期寿命是，尽管有些是 个人可以生存长达20年。 75％的ADRD患者将在80岁时接受NHS，而 4％的普通人群。在ADRD的个体中，约有70％的人将死亡。两者都长 疾病的持续时间和对NH护理的依赖提高了护理质量的改善的重要性 提供给NH的长期NH居民。医师的参与对于提供长期护理至关重要 NHS中有ADRD的居民高质量。在NHS中，医生负责开发和监督 居民的综合护理计划。 NH护理专业的医师专业化可能会通过 发展NH法规，药物指南和NH居民面临的常见行为综合症的知识 与Adrd。 NH护理专业化也可以帮助医生与患者建立长期关系，并 家庭/照顾者可以更好地认识两者的需求。这项研究的主要目的是确定是否 专门从事NH护理的医师为ADRD的居民提供更高质量的护理。这将通过两者完成 索赔数据的定量分析和通过NH的半结构访谈收集的定性数据分析 领导。我通过该奖项获得的培训将为我提供有关收到的临床护理的知识 ADRD患者以及定性研究方法的培训，这些研究方法补充了我已经是我已经的定量技能 具有。我通过这项培训发展的丰富技能将使我能够连接定性和 定量研究产生了急需的证据，以告知政策和临床指南，以优化角色 在护理中的医生提供给NH的长期NH居民。

项目成果

Defining the Role and Value of Physicians Who Primarily Practice in Nursing Homes: Perspectives of Nursing Home Physicians.

• DOI: 10.1016/j.jamda.2022.03.008
• 发表时间: 2022-06
• 期刊: JOURNAL OF THE AMERICAN MEDICAL DIRECTORS ASSOCIATION
• 影响因子: 7.6
• 作者: Jung, Hye-Young;Yun, Hyunkyung;O'Donnell, Eloise;Casalino, Lawrence P.;Unruh, Mark Aaron;Katz, Paul R.
• 通讯作者: Katz, Paul R.

Characteristics of Nursing Homes by COVID-19 Cases Among Staff: March to August 2020.

• DOI: 10.1016/j.jamda.2021.02.004
• 发表时间: 2021-05
• 期刊: Journal of the American Medical Directors Association
• 影响因子: 7.6
• 作者: Ryskina KL;Yun H;Wang H;Chen AT;Jung HY
• 通讯作者: Jung HY

Practice Trends and Characteristics of US Hospitalists From 2012 to 2018.

• DOI: 10.1001/jamahealthforum.2021.3524
• 发表时间: 2021-11
• 期刊: JAMA health forum
• 作者: Ryskina KL;Shultz K;Unruh MA;Jung HY
• 通讯作者: Jung HY

Perspectives of Physicians with Experience in Nursing Home Care on Telehealth Use During the COVID-19 Public Health Emergency.

• DOI: 10.1007/s11606-023-08087-6
• 发表时间: 2023-05
• 期刊: JOURNAL OF GENERAL INTERNAL MEDICINE
• 影响因子: 5.7
• 作者: Yu, Jiani;Yun, Hyunkyung;Unruh, Mark A.;O'Donnell, Eloise M.;Katz, Paul R.;Ancker, Jessica S.;Jung, Hye-Young
• 通讯作者: Jung, Hye-Young

Nursing Home Characteristics Associated With Resident COVID-19 Morbidity in Communities With High Infection Rates.

• DOI: 10.1001/jamanetworkopen.2021.1555
• 发表时间: 2021-03-01
• 期刊: JAMA network open
• 影响因子: 13.8
• 作者: Chen AT;Yun H;Ryskina KL;Jung HY
• 通讯作者: Jung HY