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: 10471316
• 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/10471316
• 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; Disincentive; Doctor of Philosophy; Elderly; Ensure; 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; Institutionalization; 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; Policy Research; Professional Competence; 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; Time; Training; Universities; Vulnerable Populations; acute care; aging in place; beneficiary; billing data; care costs; career development; college; comparison group; cost; cost outcomes; 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.

项目摘要/摘要 候选人：我是卫生学院物理治疗系的助理教授 南卡罗来纳州查尔斯顿的南卡罗来纳州医科大学的专业人士。我的长期目标是 成为一名资金充足的独立研究人员，研究了阿尔茨海默氏症患者的急性护理 疾病和相关痴呆症（ADRD）。为了实现这一目标，我将基于我的临床专业知识和 当前的研究培训。在K01时期，我设定了四个短期培训目标/目标：（1）发展 急性后护理政策的能力影响ADRD的人，（2）发展管理技能 操纵ADRD患者的Medicare数据，（3）发展诺言分数方法的能力 以及针对ADRD患者的数据的数据分析，以及（4）增强我的赠款技巧，道德行为 研究以及职业发展和进步的心态技能。 指导团队：我的主要导师是吉特·辛普森（Kit Simpson），德尔夫（Drph OTR。心理团队的其他成员包括Annie Simpson博士，Jacobo Mintzer，MD，MBA和MBA和 Kathryn H Bowles博士，RN，FAAN，FACMI。我的心理团队具有很高的资格，包括全国范围内 国际公认的卫生服务研究专家（K. Simpson），急性护理质量措施 （K. Ottenbacher），Adrd（J。Mintzer），观察性研究的研究设计和分析方法（A. 辛普森（Simpson）以及家庭健康实践，政策和研究（K. Bowles）。我的心理团队将指导职业 开发活动和参与K01研究。 研究策略：Medicare Home Health因1920年而发生了前所未有的变化 大流行和新的付款模式。这些巨大的变化有可能加剧现有的障碍 ADRD患者的健康访问。降低家庭健康的机会会对ADRD造成伤害 并可以引发对医疗保健系统的一系列资源和财务影响。影响 目前尚未检查ADRD患者的家庭健康访问危机和质量 需要。这个K01项目将使用匹配良好的组，以显示报销更改的影响和 通过分析，有或没有ADRD的人的家庭健康访问和结果的大流行破坏 医疗保险评估和计费数据。倾向分数方法将用于平衡患者风险因素 用于比较组。目标1：描述家庭健康获取和良好结果的差异 2019年有和没有ADRD的匹配的Medicare受益人（MBS）。目标2：检查变化 2019年与2020年的Home Health健康访问和成果。目标3：检查更改 在2019年与2021年匹配的MBS匹配组的家庭健康访问和结果中。 研究可以帮助优化ADRD和Medicare系统的人的访问，成本和结果 为倡导工作，当前的家庭健康实践以及未来的急性后护理政策提供信息。