Chronic Care Management of Geriatric Traumatic Brain Injury

老年创伤性脑损伤的长期护理管理

基本信息

批准号：
10646504
负责人：
Monique Renae Pappadis
金额：
$ 9.88万
依托单位：
UNIVERSITY OF TEXAS MED BR GALVESTON
依托单位国家：
美国
项目类别：
财政年份：
2020
资助国家：
美国
起止时间：
2020-08-01 至 2025-05-31
项目状态：
未结题

来源：
https://reporter.nih.gov/project-details/10646504
关键词：
Acceleration Accident and Emergency department Accounting Acute Address Administrator Age Area Brain Injuries Caregivers Caring Case Manager Cessation of life Characteristics Chronic Chronic Care Chronic Disease Communities Continuity of Patient Care Data Decision Making Development Disease Disease model Elderly Epidemic Ethnic Origin Evidence based intervention Exclusion Foundations Funding Future Geriatrics Goals Health Health Personnel Health Policy Health Services Home Home Nursing Care Hospitalization Hospitals Incidence Individual Injury Institutionalization Intervention Interview Long-Term Care Long-Term Care Nursing Longevity Managed Care Medicare Mentored Research Scientist Development Award Mentors Mentorship Methodology Methods Modeling Nurses Nursing Homes Occupational Occupational Therapy Outcome Outcome Study Patients Pattern Patterns of Care Persons Physical therapy Physicians Play Process Provider Public Health Quality of Care Race Recommendation Research Research Activity Research Personnel Risk Role Services Severities Social Workers Socioeconomic Status Speech Speech Therapy Structure Symptoms Time Training Training Activity Translating Traumatic Brain Injury United States National Institutes of Health Visit acute care advanced analytics aged barrier to care behavioral health care delivery care outcomes care providers career career development clinical care cohort comorbidity disability ethnic minority evidence base health care delivery health care disparity health care service utilization health disparity hospital readmission human old age (65+)implementation science improved intervention mapping medical specialties neighborhood disadvantage primary care visit programs satisfaction sex skills sociodemographics socioeconomic disadvantage stakeholder perspectives therapy development treatment as usual

项目摘要

ABSTRACT Traumatic brain injury (TBI) among older adults has emerged as a new silent epidemic. Older age is associated with long-lasting symptoms and poorer outcomes after injury. A need exists for an acute-to-chronic disease model of traumatic brain injury to guide the chronic care management of older adults with TBI. Limited evidence exists on the patterns and continuity of care following discharge from acute and post-acute care to the community after TBI. This mixed-methods Mentored Research Scientist Development Award (K01) will generate data on the patterns and continuity of care to identify disparities in care and inform initiatives to improve quality of care of older adults with TBI following hospital discharge. The overarching goal of this NIA K01 award is to provide the candidate with a better understanding of the needs and provision of care of older adults with TBI, advanced analytical skills to evaluate care delivery, skills in translating evidence into health initiatives to improve care, and development of an independent research program contributing to improving health outcomes of older adults with TBI. The candidate's mentoring team includes well-established researchers in geriatric medicine, post-acute care, health services, mixed methodology, quality improvement, implementation sciences, and health disparities. The candidate will receive mentorship and training in four essential areas to achieve her career goals, which are to: (1) understand the clinical care processes and health care policies influencing health care delivery of older adults; (2) increase proficiency in advanced analytical approaches to evaluate health care delivery for older adults using administrative claims data; (3) develop, adapt, and evaluate real-world evidence-based interventions to improve health care delivery for older adults; and (4) accelerate career trajectory to becoming an NIH-funded investigator focused on improving care for older adults with TBI. Using Medicare data (2015-2018), the training activities will prepare her to address the following specific aims, which are to: (1) determine the patterns of care in older adults with TBI during the year following acute discharge; (2) explore facilitators and barriers to continuity of care, and elicit stakeholder recommendations to improve care following acute discharge among older adults with TBI, caregivers, and healthcare personnel; and (3) examine the association between continuity of care and health outcomes following acute discharge among older adults with TBI. The findings from this K01 will contribute to describing current practice, and integrate stakeholder perspectives to guide efforts to address disparities in care receipt. Through the research aims and career development training activities, the candidate will be better equipped to submit an R01 to evaluate the effect of implementing an evidence-based, patient-informed transitional care intervention to improve care continuity and health outcomes following discharge among older adults with TBI.

抽象的老年人中的创伤性脑损伤（TBI）已成为一种新的无声流行病。较大的年龄是与长期持续的症状和受伤后较差的结果有关。需要从急性到慢性创伤性脑损伤疾病模型，指导患有 TBI 的老年人的长期护理管理。有限的存在关于急性期和急性后护理出院后的护理模式和连续性的证据 TBI 后的社区。该混合方法指导研究科学家发展奖（K01）将生成有关护理模式和连续性的数据，以确定护理方面的差异，并为采取行动提供信息提高患有 TBI 的老年人出院后的护理质量。本次 NIA 的总体目标 K01奖旨在让候选人更好地了解老年人的需求和提供护理服务患有 TBI 的成年人、评估护理服务的高级分析技能、将证据转化为健康的技能改善护理的举措，以及制定有助于改善护理的独立研究计划患有 TBI 的老年人的健康结果。候选人的指导团队包括成熟的老年医学、急性后护理、卫生服务、混合方法、质量改进的研究人员，实施科学和健康差异。候选人将接受四个方面的指导和培训实现职业目标的重要领域是：（1）了解临床护理流程和健康状况影响老年人医疗保健服务的护理政策； (2) 提高高级分析能力使用行政索赔数据评估老年人医疗保健服务的方法；（3）开发，适应并评估现实世界的循证干预措施，以改善老年人的医疗保健服务； (4) 加快职业轨迹，成为 NIH 资助的研究员，专注于改善对患者的护理患有 TBI 的老年人。使用 Medicare 数据（2015-2018），培训活动将使她做好准备解决以下问题：以下具体目标是： (1) 确定年内患有 TBI 的老年人的护理模式急性出院后； (2) 探索护理连续性的促进因素和障碍，并引出利益相关者改善患有 TBI 的老年人、护理人员和患者急性出院后护理的建议医护人员； (3) 检查护理连续性与健康结果之间的关联患有 TBI 的老年人急性出院后。 K01 的研究结果将有助于描述现行做法，并整合利益相关者的观点来指导解决护理接受方面的差异的努力。通过研究目标和职业发展培训活动，候选人将更好地适应提交 R01 来评估实施循证、患者知情的过渡护理的效果旨在改善患有 TBI 的老年人出院后的护理连续性和健康结果的干预措施。