Quantifying the Burden of Disease and Healthcare Need in Veterans and Civilians

量化退伍军人和平民的疾病负担和医疗保健需求

基本信息

批准号：
10845255
负责人：
Katherine JoAnn Hoggatt
金额：
--
依托单位：
VA GREATER LOS ANGELES HEALTHCARE SYSTEM
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：
2020-10-01 至 2023-03-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/10845255
关键词：
20 year old Acceleration Achievement Affordable Care Act Age Behavioral Risk Factor Surveillance System Caring Clinic Communities Community Health Community Healthcare Comprehensive Health Care Consensus Data Drug usage Elderly man Ensure Ethnic Origin Evaluation Foundations Funding Gender General Population Geographic Locations Goals Health Health Services Accessibility Health Status Health behavior Healthcare Healthcare Systems Impairment Injury Integrated Health Care Systems Knowledge Learning Marketing Measures Medical Medicare Mental Health Methodology Methods Modernization National Health Interview Survey Outcome Outcome Study Outpatients Patients Pattern Policies Policy Maker Population Population Characteristics Population Distributions Prevalence Preventive care Private Sector Privatization Probability Process Provider Public Sector Race Readiness Reporting Research Resources Risk Risk Factors Services Source Subgroup Surveys System Time Update Veterans Veterans Health Administration Vision Visual War Work burden of illness care outcomes comorbidity comparative data warehouse demographics design evidence based guidelines health care availability health care service health care service utilization health difference health equity health plan health related quality of life improved innovation integrated care neglect physical conditioning programs provider networks routine practice secondary analysis sociodemographics

项目摘要

Background: With rapid acceleration of Veterans’ use of care in the community, limited data exist to prepare community providers and others in the broader VA integrated care network. Many community providers and health plans may assume Veteran patients are similar to their routine practice populations, composed primarily of civilians, although prior research would suggest otherwise. Significance/Impact: The proposed study will use detailed, current, and comprehensive data from the Behavioral Risk Factor Surveillance System (BRFSS), National Health Interview Survey (NHIS), the National Surveys on Drug Use and Health (NSDUH), and VA Corporate Data Warehouse (CDW) to quantify broadly the distribution of health and healthcare factors for Veterans, VA users, and VA non-users and to evaluate in-depth the factors that differ between Veterans and civilians. This information will not only substantially update our knowledge of how Veterans are similar to or different from civilians but will also be used by VA policymakers to improve the design and readiness of community care partners as VA referrals increase. Innovation: In contrast to previous studies and reports using national survey data, the proposed project will include VA data to provide a richer description of VA patients than is possible using only publicly-available data on VA users, and examine in depth the patterns in Veterans’ health and healthcare across subgroups and over time. The proposed research has no corollary or antecedent study in VA HSR&D’s or QUERI’s portfolio, and of the studies funded outside the VA that use one or more of these sources and is underway or recently completed, none proposed to use VA data or to combine the breadth and depth of the proposed project Specific Aims: This project aims to 1. Quantify the distribution of population characteristics, health behaviors, health conditions, health status, access to care, and healthcare utilization among Veterans overall and among VA users and non-users; 2. Evaluate the extent to which patterns in population-, health-, and healthcare- related factors differ between Veterans and civilians; 3. Determine whether the patterns identified under Aims 1 and 2 vary for subgroups defined by age, gender, and race-ethnicity; and, 4. Conduct an expert panel to review results from Aims 1-3 to come to consensus on evidence-based recommendations for improved community care (e.g., community provider readiness) and health equity. Methodology: We will conduct a secondary analysis using multiple years of data from BRFSS, NHIS, NSDUH, and VA CDW. Our analyses will include measures for Veteran and VA user status, geographic region, population characteristics, health behaviors and conditions, and healthcare outcomes, such as access, utilization, and unmet need for care. We will quantify the distribution of population-, health-, and healthcare- related factors among Veterans, VA users, and VA non-users, evaluate how these factors differ between Veterans and civilians, assess the extent to which VA use moderates differences between Veterans and civilians, and assess how patterns for Veterans differ across population subgroups. We will use modified Delphi panel methods to critically appraise findings, rate their importance, feasibility, and potential for Veteran impacts, and come to consensus on evidence-based recommendations for community care and health equity. Next Steps/Implementation: We will engage diverse stakeholders as advisors/panelists (e.g., national program office, VISN, VAMC and Veteran representatives) in design of dissemination products (e.g., fact sheets, visual abstracts) for different venues that meet end user needs in addition to traditional scientific products. Integrated into the panel process will be explicit planning for products capable of informing and supporting potential practice and policy changes and their subsequent implementation.

背景：随着退伍军人在社区中使用护理服务的迅速加速，可供准备的数据有限更广泛的 VA 综合护理网络中的社区提供者和其他人许多社区提供者和其他人。健康计划可能假设退伍军人患者与其常规执业人群相似，主要由平民，尽管之前的研究表明并非如此。意义/影响：拟议的研究将使用来自行为危险因素监测系统 (BRFSS)、国家健康访谈调查 (NHIS)、国家药物使用与健康调查 (NSDUH) 和 VA 企业数据仓库 (CDW) 广泛量化退伍军人、VA 用户和 VA 非用户的健康和医疗保健因素的分布，并进行深入评估退伍军人和平民之间的差异因素不仅会大大更新我们的信息。了解退伍军人与平民有何相似或不同之处，但也将被退伍军人管理局政策制定者用来随着 VA 转介的增加，改善社区护理合作伙伴的设计和准备情况。创新：与之前使用国家调查数据的研究和报告相比，拟议的项目将包含 VA 数据，以提供比仅使用公开数据更丰富的 VA 患者描述退伍军人管理局用户，并深入研究跨亚组和以上退伍军人的健康和医疗保健模式拟议的研究在 VA HSR&D 或 QUERI 的投资组合中没有推论或先行研究，并且退伍军人事务部以外资助的研究使用这些来源中的一个或多个并且正在进行或最近已完成，没有人建议使用 VA 数据或结合拟议项目的广度和深度具体目标：该项目旨在 1. 量化人口特征、健康行为、总体退伍军人和退伍军人之间的健康状况、健康状况、获得护理的机会和医疗保健利用率 VA 用户和非用户； 2. 评估人口、健康和医疗保健模式的程度 3. 确定目标 1 中确定的模式是否存在 2 根据年龄、性别和种族民族定义的亚组有所不同；以及 4. 组建专家小组进行审查；目标 1-3 的结果旨在就改善社区的基于证据的建议达成共识护理（例如，社区提供者的准备情况）和健康公平。方法：我们将使用来自 BRFSS、NHIS、 NSDUH 和 VA CDW 我们的分析将包括退伍军人和 VA 用户状态、地理位置的衡量标准。地区、人口特征、健康行为和状况以及医疗保健结果，例如获取、我们将量化人口、健康和医疗保健的分布。退伍军人、VA 用户和 VA 非用户之间的相关因素，评估这些因素在退伍军人和平民，评估退伍军人管理局的使用在多大程度上缓和了退伍军人和平民之间的差异平民，并评估退伍军人的模式在不同人群中的差异，我们将使用修改后的方法。德尔菲小组方法批判性地评估研究结果，评价其重要性、可行性和退伍军人潜力影响，并就社区护理和健康公平的循证建议达成共识。后续步骤/实施：我们将让不同的利益相关者作为顾问/小组成员（例如国家计划办公室、VISN、VAMC 和退伍军人代表）参与传播产品的设计（例如事实除了传统的科学知识外，还可以满足最终用户的需求集成到小组流程中的将是对能够提供信息和信息的产品的明确规划。支持潜在的实践和政策变化及其后续实施。