Impact of the HRSA Health Disparities Collaboratives

HRSA 健康差异合作组织的影响

基本信息

批准号：
6666823
负责人：
EDWARD GUADAGNOLI
金额：
$ 53.64万
依托单位：
HARVARD MEDICAL SCHOOL
依托单位国家：
美国
项目类别：
财政年份：
2002
资助国家：
美国
起止时间：
2002-09-30 至 2005-09-29
项目状态：
已结题

项目摘要

DESCRIPTION: This application is in response to a request by AHRQ (RFA HS-02-005) for investigators to assess the impact of the Health Disparities Collaboratives on the processes and outcomes of care provided to patients cared for at participating health centers. We will study health centers that participated in the Diabetes II and Diabetes III Collaboratives, the Cardiovascular Collaborative, and the Asthma I and II Collaboratives. We will describe the interventions implemented by participating health centers; the patient populations served by the centers; the structure, staffing, organization, management, leadership, and culture of the centers; and the external partnerships formed with local, state, and national organizations. We will achieve this by conducting interviews with key clinical and administrative leaders at the health centers and the regional clusters; by reviewing monthly reports submitted by health centers to their Cluster Directors; and by reviewing other materials generated by staff from health centers and clusters. In addition to using these data to document what the health centers have accomplished, we will combine them with information on the processes and outcomes of care collected from patients' medical records and address the following specific aims: 1)evaluate whether participation in a Health Disparities Collaborative leads to improved processes and outcomes of care. and 2)identify the characteristics of the health centers, improvement teams, and improvement methods associated with positive change in quality of care. For each disease, we will sample 15 health centers that participated in a Collaborative and collect processes of care and outcomes data from the medical charts of 35 patients per center who received care prior to participation and 35 patients per center who received care following participation. The same number of patients with one of the conditions not targeted for intervention will be sampled at each of these health centers. The latter patients will comprise one of the control samples for our analyses. In addition, from a matched sample of 15 health centers that did not participate in a Collaborative, but that are otherwise eligible to do so, we will collect data from medical records of 70 patients per center per condition. Half of these patients will be sampled to coincide with a time period prior to the Collaboratives and half will be sampled to coincide with a period following the Collaboratives. These patients represent a second control sample for our analyses. Overall, we will study a total of 60 health centers and 9,450 patients (3,150 per condition). The results of this study will indicate whether the Health Disparities Collaboratives are nearer their goal of providing 100 percent access and eliminating disparities.

描述：此申请是响应AHRQ（RFA HS-02-005）的请求，以评估调查人员评估健康差异协作对提供给参与卫生中心照料患者的过程和护理结果的影响。我们将研究参加糖尿病II和糖尿病III合作社，心血管协作以及哮喘I和II合作社的健康中心。我们将描述参与卫生中心实施的干预措施；中心服务的患者人群；中心的结构，人员配备，管理，管理，领导和文化；以及与地方，州和国家组织建立的外部伙伴关系。我们将通过对卫生中心和区域集群的主要临床和行政领导者进行访谈来实现这一目标；通过审查卫生中心提交的每月报告给其集群董事；并审查由卫生中心和集群的工作人员生成的其他材料。除了使用这些数据来记录健康中心的成就外，我们还将将它们与有关患者病历收集的过程和护理结果的信息结合在一起，并解决以下具体目的：1）评估是否参与健康差异协作导致了改进的过程和护理结果。 2）确定与护理质量变化相关的卫生中心，改进团队的特征和改进方法。对于每种疾病，我们将对15个卫生中心进行采样，这些中心参加了协作和收集护理和结果的过程，从每个中心的35名患者的医疗图表中，他们在参与前接受护理，每个中心35名患者参加了护理。这些卫生中心中的每个疾病中未针对干预措施的患者数量相同。后一种患者将包括我们分析的对照样本之一。此外，从没有参加合作的15个卫生中心的匹配样本中，否则有资格这样做，我们将从每个中心70名患者的病历中收集数据。这些患者中有一半将与在协作之前的时间段相吻合，一半将与协作后的一段时间相吻合。这些患者代表了我们分析的第二个对照样本。总体而言，我们将研究总共60个卫生中心和9,450名患者（每种情况3,150例）。这项研究的结果将表明健康差异协作是否更接近其提供100％访问和消除差异的目标。