Competitive Bidding in Medicare and the Implications for Home Oxygen Therapy in COPD

医疗保险竞争性招标以及对慢性阻塞性肺病家庭氧疗的影响

基本信息

批准号：
10641360
负责人：
Kevin Duan
金额：
$ 18.86万
依托单位：
UNIVERSITY OF WASHINGTON
依托单位国家：
美国
项目类别：
财政年份：
2023
资助国家：
美国
起止时间：
2023-04-26 至 2023-07-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/10641360
关键词：
Accounting Address Affect American American Lung Association Area Award Caring Cause of Death Cessation of life Chest Chronic Chronic Obstructive Pulmonary Disease Clinic Clinical Clinical Investigator Competitive Bidding Contracts Data Set Development Plans Diabetes Mellitus Disease Outcome Durable Medical Equipment Environment Equipment Foundations Future Geographic Locations Geography Goals Grant Health Health Policy Health system Healthcare Systems Home Hospitalization Inpatients Interview Knowledge Life Measures Medicare Medicare claim Mentors Methodology Methods Monitor Morbidity - disease rate Nurses Outcome Oxygen Oxygen Therapy Care Participant Patient Care Patient Preferences Patient-Focused Outcomes Patients Physicians Policies Policy Research Population Population Study Price Probability Process Professional Organizations Provider Public Health Qualitative Research Quasi-experiment Research Research Activity Research Methodology Research Personnel Research Training Respiratory Disease Sampling Services Societies Structure System Testing Training Training Activity United States United States Department of Veterans Affairs Universities Voice Washington beneficiary burden of illness career career development clinical center cost design experience improved innovation insight medical schools mortality negative affect patient oriented payment primary outcome programs respiratory respiratory health secondary outcome sound

项目摘要

PROJECT SUMMARY/ABSTRACT Chronic obstructive pulmonary disease (COPD) causes the largest burden of disease among chronic respiratory conditions in the United States, affecting 16 million Americans and leading to 150,000 deaths annually. Home oxygen therapy is one of few therapies in COPD that reduces mortality. Over the last decade, a Medicare policy, the Competitive Bidding Program (CBP), has significantly changed the price of home oxygen and the number of suppliers servicing patients. The effect of this policy has not been studied extensively and is currently unknown. Professional societies have voiced concern that patient access to home oxygen and its associated clinical benefits have been negatively affected. On the other hand, program monitoring by Medicare has not revealed any unintended consequences of the CBP. This mixed methods study proposes to use quasi-experimental observational methods and semi-structured qualitative interviews to independently and rigorously evaluate the effects of the CBP on home oxygen access and clinical outcomes among patients with COPD. Dr. Duan will (1) assess the effect of the CBP on access to home oxygen among patients with COPD, (2) examine the association between the CBP and patient-centered clinical outcomes among patients with COPD, and (3) identify patient and provider perspectives about their current experience with home oxygen prescribing. This proposal will generate important policy and patient care insights that have the potential to inform CBP redesign and lay the foundation for future strategies to improve home oxygen care. Through this grant, Dr. Duan, an early career investigator and pulmonologist, will receive training in advanced causal inference methods, the analysis of large administrative datasets for policy research, and qualitative research methods. The proposed research and comprehensive career development plan will prepare Dr. Duan for a career as an independent investigator studying how health systems and policies can be optimized to improve respiratory health and value for patients. These research and training activities will be supervised by an expert team of mentors at the academically rich research environments of the University of Washington Schools of Medicine and Public Health, as well as the Department of Veterans Affairs Puget Sound Health Care System.

项目摘要/摘要慢性阻塞性肺疾病（COPD）导致慢性疾病负担最大美国的呼吸状况，影响1600万美国人，导致150,000人死亡每年。家庭氧疗法是COPD中少数降低死亡率的疗法之一。在过去的十年中， Medicare政策是竞争性招标计划（CBP），已大大改变了房屋的价格氧气和为患者服务的供应商数量。该政策的效果尚未研究广泛，目前未知。专业社会表示担心患者进入家氧及其相关的临床益处受到负面影响。另一方面，程序 Medicare的监视尚未揭示CBP的任何意外后果。这项混合方法研究建议使用准实验观测方法和半结构定性访谈以独立，严格评估CBP对家庭氧气的影响 COPD患者的临床结果。 Duan博士（1）评估CBP对访问的影响 COPD患者的家用氧气，（2）检查CBP与以患者为中心的关联 COPD患者的临床结果，（3）确定患者和提供者的观点当前使用家用氧气处方的经验。该建议将产生重要的政策和患者护理有可能告知CBP重新设计并为未来改进的策略奠定基础的见解家庭氧气护理。通过这笔赠款，早期职业调查员兼肺科医生Duan博士将接受高级培训因果推理方法，大型行政数据集的政策研究分析以及定性研究方法。拟议的研究和全面的职业发展计划将为Duan博士做好准备作为独立调查员的职业，研究如何将卫生系统和政策优化为改善患者的呼吸健康和价值。这些研究和培训活动将由华盛顿大学学术丰富的研究环境的指导专家团队医学和公共卫生学校以及退伍军人事务部普吉特湾健康护理系统。