Potential New Barriers to Home Health Access for People with Alzheimer's Disease and Related Dementias

阿尔茨海默病和相关痴呆症患者获得家庭健康的潜在新障碍

• 批准号: 10689133
• 负责人: Sara Knox
• 金额: $ 13.78万
• 依托单位: MEDICAL UNIVERSITY OF SOUTH CAROLINA
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-09-01 至 2026-06-30
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10689133
• 关键词: Acute; Admission activity; Advocacy; Affect; Alzheimer' s disease related dementia; Behavioral Symptoms; COVID-19; COVID-19 pandemic; Career Mobility; Caring; Characteristics; Clinical; Communities; Competence; Complex; Data; Data Analyses; Doctor of Philosophy; Elderly; Equilibrium; Ethics; Funding; Future; Goals; Grouping; Health; Health Occupations; Health Policy; Health Services Research; Healthcare Systems; Home; Home Care Services; Home Health Agency; Hospitalization; Individual; Institution; Institutionalized Persons; International; Length; Link; Matched Group; Measures; Medical; Medicare; Mentors; Mentorship; Methods; Modeling; Observational Study; Outcome; Outcome Measure; Patient Preferences; Patient risk; Patients; Persons; Physical therapy; Policies; Professional Competence; Qualifying; Quality of Care; Quality of life; Research; Research Design; Research Personnel; Research Training; Resources; Risk Factors; Scoring Method; Services; Source; South Carolina; Stress; System; Techniques; Training; Universities; Vulnerable Populations; acute care; aging in place; beneficiary; billing data; care costs; career development; college; comparison group; cost; economic implication; experience; functional decline; health care service; health practice; hospital readmission; member; operation; pandemic disease; patient population; payment; professor; psychological symptom; skills; trend; waiver

PROJECT SUMMARY/ABSTRACT Candidate: I am an assistant professor in the Division of Physical Therapy in the College of Health Professions at the Medical University of South Carolina in Charleston, South Carolina. My long-term goal is to become a well-funded, independent researcher investigating post-acute care of individuals with Alzheimer’s Disease and Related Dementias (ADRD). To achieve this goal, I will build upon my clinical expertise and current research training. For the K01 period, I have set four short term training goals/objectives: (1) Develop competence in post-acute care policy impacting people with ADRD, (2) Develop skills in management and manipulation of Medicare data of people with ADRD, (3) Develop competence in propensity score methods and data analysis for data of people with ADRD, and (4) Enhance my grantsmanship, ethical conduct of research, and mentorship skills for career development and advancement. Mentoring Team: My Primary Mentor is Kit Simpson, DrPH and my Co-Mentor is Kenneth Ottenbacher, PhD, OTR. Additional members of the mentoring team include Annie Simpson PhD, Jacobo Mintzer, MD, MBA, and Kathryn H Bowles PhD, RN, FAAN, FACMI. My mentoring team is highly qualified and includes nationally and internationally recognized experts in health services research (K. Simpson), post-acute care quality measures (K. Ottenbacher), ADRD (J. Mintzer), study design and analysis methods for observational studies (A. Simpson), and home health practice, policy, and research (K. Bowles). My mentoring team will guide career development activities and participate in the K01 research. Research Strategy: Medicare home health underwent unprecedented changes in 2020 due to the COVID-19 pandemic and a new payment model. These vast changes threaten to exacerbate existing barriers to home health access for people with ADRD. Decreased access to home health causes harm to people with ADRD and can trigger a cascade of resource and financial implications for the health care system. Impacts of the current crisis on home health access and quality for people with ADRD has not been examined but is urgently needed. This K01 project will use well matched groups, to show the impact of reimbursement change and pandemic disruption on home health access and outcomes for people with and without ADRD through analysis of Medicare assessment and billing data. Propensity score methods will be used to balance patient risk factors for comparison groups. Aim 1: Describe differences in home health access and outcomes between well- matched groups of Medicare Beneficiaries (MBs) with and without ADRD in 2019. Aim 2: Examine changes in home health access and outcomes for well-matched groups of MBs in 2019 vs 2020. Aim 3: Examine changes in home health access and outcomes for well-matched groups of MBs in 2019 vs 2021. Findings from this study can help to optimize access, cost, and outcomes for people with ADRD and the Medicare system and inform advocacy efforts, current home health practice, and future post-acute care policies.

项目概要/摘要 应聘者：我是健康学院物理治疗系助理教授 位于南卡罗来纳州查尔斯顿的南卡罗来纳医科大学的专业我的长期目标是。 成为一名资金充足的独立研究人员，研究阿尔茨海默氏症患者的急性后期护理 为了实现这一目标，我将利用我的临床专业知识和知识。 对于K01时期的研究培训，我设定了四个短期培训目标：（1）发展。 影响 ADRD 患者的急性后护理政策的能力，(2) 培养管理和 处理 ADRD 患者的医疗保险数据，(3) 培养倾向评分方法的能力 对 ADRD 患者的数据进行数据分析，以及 (4) 增强我的资助能力和道德行为 职业发展和进步的研究和指导技能。 指导团队：我的主要导师是 Kit Simpson 博士，我的共同导师是 Kenneth Ottenbacher 博士 OTR 指导团队的其他成员包括 Annie Simpson 博士、Jacobo Mintzer 医学博士、MBA 和 Kathryn H Bowles 博士、注册护士、FAAN、FACMI 我的导师团队素质很高，包括国内和国外的人员。 国际公认的卫生服务研究专家（K. Simpson）、急性后护理质量措施 (K. Ottenbacher)、ADRD (J. Mintzer)、观察性研究的研究设计和分析方法 (A. Simpson），以及家庭健康实践、政策和研究（K. Bowles）。我的指导团队将指导职业生涯。 开发活动并参与K01研究。 研究策略：由于 COVID-19，医疗保险家庭健康在 2020 年经历了前所未有的变化 大流行和新的支付模式可能会加剧现有的家庭障碍。 减少 ADRD 患者获得家庭保健的机会会对 ADRD 患者造成伤害。 并可能引发对医疗保健系统的一系列资源和财务影响。 当前 ADRD 患者的家庭保健获取和质量危机尚未得到审查，但已迫切需要解决 这个 K01 项目将使用匹配良好的组来显示报销变化的影响和 通过分析，流行病对患有和不患有 ADRD 的人的家庭健康获取和结果造成干扰 医疗保险评估和计费数据将用于平衡患者风险因素。 目标 1：描述健康人群在家庭健康获取和结果方面的差异。 2019 年有和没有 ADRD 的医疗保险受益人 (MB) 的匹配组。目标 2：检查 2019 年与 2020 年相比，匹配的 MB 群体的家庭健康获取和结果。目标 3：检查变化 2019 年与 2021 年相比，匹配的 MB 群体的家庭健康获取和结果方面的差异。调查结果 研究可以帮助优化 ADRD 患者和医疗保险系统的获取、成本和结果， 为宣传工作、当前的家庭健康实践和未来的急性后护理政策提供信息。

项目成果

Successful Discharge to Community From Home Health Less Likely for People in Late Stages of Dementia.

对于痴呆症晚期患者来说，从家庭健康中心成功出院到社区的可能性较小。

• DOI: 10.1519/jpt.0000000000000383
• 发表时间: 2024
• 期刊: Journal of geriatric physical therapy (2001)
• 作者: Knox,Sara;Downer,Brian;Haas,Allen;Ottenbacher,KennethJ
• 通讯作者: Ottenbacher,KennethJ