Project 2: The Intersection of Telehealth and Health Disparities in At-Risk Older Patients with Cancer

项目 2：远程医疗与高危老年癌症患者健康差异的交叉点

基本信息

批准号：
10762145
负责人：
Melody K Schiaffino
金额：
$ 24.45万
依托单位：
SAN DIEGO STATE UNIVERSITY
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：
2023-09-19 至 2028-08-31
项目状态：
未结题

来源：
https://reporter.nih.gov/project-details/10762145
关键词：
Address Adverse event COVID-19 pandemic California Cancer Patient Caring Catchment Area Cohort Studies Communication Complement County Data Data Set Databases Development Disparity Elderly Emergency department visit Environment Equity Ethnic Origin Future Health Services Accessibility Health system Healthcare Healthcare Systems Hospitalization Hospitals Household Improve Access Income Individual Inequality Inequity Internet Intervention Knowledge Language Link Logistic Regressions Low income Malignant Neoplasms Medicare Medicare claim Medicare/Medicaid Methods Modeling Oncology Outcome Patient Care Patient-Focused Outcomes Patients Perception Persons Policies Policy Maker Population Populations at Risk Positioning Attribute Provider Quality of Care Race Research Risk Safety Secondary to Socioeconomic Status Surveys Technology Telecommunications Testing Visit Vulnerable Populations access disparities adverse outcome anticancer research beneficiary cancer care cancer education cancer health disparity cancer risk care delivery care outcomes disparity reduction ethnic minority experience health disparity health equity improved interest marginalized population neoplasm registry older patient pandemic disease patient population patient-level barriers population based post-COVID-19 provider-level barriers racial minority response telehealth

项目摘要

PROJECT SUMMARY/ ABSTRACT – PROJECT 2 Telehealth utilization increased rapidly across the US healthcare system in response to the COVID-19 pandemic. As we emerge from the pandemic, telehealth has become a new option for communication between patients and providers. Cancer care delivery appears well positioned to incorporate telehealth into the standard workflow of patient care. Furthermore, equitable implementation of telehealth could potentially increase access to care among vulnerable patients. However, emerging data suggest disparities with telehealth utilization access among non-White, low income, and non-English speaking individuals. Inequitable implementation of telehealth could inadvertently create barriers among our most vulnerable patients, which could paradoxically increase cancer health disparities. Large-scale rigorous research evaluating disparities in telehealth utilization within the post-COVID-19 cancer care environment is lacking. Furthermore, research has not addressed how telehealth utilization influences safety and quality of care compared to conventional in-person visits, particularly among our at-risk populations with higher baseline risks of poor outcomes and adverse events. Finally, a comprehensive understanding of telehealth disparities requires an understanding of patient perceptions and provider biases towards telehealth, which represent important unaddressed questions. To fill these critical knowledge gaps, we propose a comprehensive population-based cohort study among Medicare beneficiaries with cancer, incorporating linkages to secondary datasets providing data on providers, hospitals, and regional factors. We will assess the impact of telehealth on vulnerable cancer populations through the following aims: 1) identify and characterize disparities in telehealth during and after the COVID-19 pandemic; 2) assess the impact of telehealth on efficacy and safety of cancer delivery among at-risk populations; and 3) define actionable patient-level barriers and provider biases with telehealth utilization. This proposed study will help define the national landscape of telehealth among cancer patients, and will provide a framework for the development of future interventions to optimize telehealth among at-risk patients. This timely project will deliver actionable information to providers, healthcare systems, and policymakers. Overall, equitable, safe, and effective telehealth delivery stands to increase access to care and reduce cancer health disparities among our most vulnerable cancer patients.

项目摘要/摘要 - 项目2 在美国医疗系统中，远程医疗利用率迅速增加大流行。患者和提供者。患者护理的工作流程。但是，在脆弱的患者中，新兴数据表明远程医疗非白人，低收入和非英语的人之间的访问远程医疗可以在我们最脆弱的患者中创造出创造力，从而在氧气上造成障碍增加癌症健康差异。在CoVID后19日，缺乏癌症护理环境。与传统的亲自访问相比，远程医疗利用影响安全和护理质量，特别是在我们的高风险人口中，有危险的结果和不利事件对远程医疗差异的全面理解需要了解公民责任和提供者对远程医疗的偏见，这些远程医疗是未解决的问题。知识差距，我们建议对医疗保险受益人进行一项基于汇编的人群研究使用癌症，将与辅助数据集结合在一起，提供有关提供者和区域的数据因素。确定和表征远程医疗期间和之后的差异； 2）评估您远程医疗对处于危险的人群的疗效和安全性的影响；具有远程医疗利用率的患者级别障碍和提供者偏见。在癌症患者中定义远程医疗的国家景观，并将为他们提供框架开发未来的干预措施，以优化高危患者的远程医疗。提供者，医疗保健系统和政策制定者的可行信息。有效的远程医疗服务可以照顾您的护理和减少我们的癌症健康差异最脆弱的癌症患者。