Disasters and Hospital Systems Serving Health Disparity Populations: Identifying the Long Term effects of the COVID-19 Pandemic to Mitigate Future Challenges

为健康差异人群提供服务的灾害和医院系统：确定 COVID-19 大流行的长期影响以缓解​​未来的挑战

• 批准号: 10584977
• 负责人: Eric Goralnick
• 金额: $ 72.64万
• 依托单位: BRIGHAM AND WOMEN'S HOSPITAL
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-07-15 至 2026-12-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10584977
• 关键词: Address; Administrator; Affect; American Hospital Association; COVID-19; COVID-19 pandemic; COVID-19 pandemic effects; Case Study; Characteristics; Communities; Complex; Consensus; Data Sources; Disasters; Emergency Situation; Engineering; Event; Face; Financial cost; Frequencies; Future; Goals; Health; Health Care Coalitions; Health Status; Health protection; Health system; Healthcare; Healthcare Systems; Hospitals; Intervention; Interview; Investigation; Link; Long-Term Effects; Longitudinal Studies; Medicaid; Medical; Medicine; Methods; Morbidity - disease rate; Nature; Outcome; Patients; Persons; Play; Policies; Population; Preparation; Public Health; Readiness; Recommendation; Recovery; Reduce health disparities; Resources; Role; Sampling; Services; Structure; Surveys; System; Time; Uninsured; United States National Academy of Sciences; Variant; Vulnerable Populations; Work; climate disaster; design; ethnic minority; experience; health disparity populations; improved; innovation; lens; long term consequences of COVID-19; man-made disasters; member; mortality; operation; outcome disparities; pandemic disease; patient population; policy recommendation; programs; promote resilience; racial minority; resilience; response; severe weather; social; societal costs; stressor; success; underserved community; virtual; weather-related disaster

Hospital Systems Serving Health Disparity Populations (HSSHDPs) deliver needed services to racial and ethnic minorities and other underserved communities. HSSHDPs may experience long-term effects of natural and man-made disasters that in turn could affect health outcomes for the populations they serve. The COVID- 19 pandemic has affected virtually every US healthcare system and, therefore, provides a unique opportunity to study the effects of large-scale and long-term stressors on under-resourced systems serving vulnerable patient populations. Using the framework of the disaster management cycle (mitigation, preparedness, response, and recovery), this project proposes to conduct a mixed methods study of the long-term effects of COVID-19 on US hospitals across four critical domains (quality, workforce, finances, and innovation), with a special focus on HSSHDPs and on the health disparity populations they serve. This project will be the first major national investigation of the effects of a national disaster on HSSHDPs. This rigorous mixed methods study will be significant in identifying HSSDHPS most and least affected by the COVID-19 pandemic and will deepen the understanding of the contributing factors that led to successes and challenges. The study will identify actionable best practices and challenges to HSSHDPs' operations before, during and after the COVID-19 pandemic. The specific aims of this study are: Aim 1. Describe the long-term effects of COVID-19 on hospitals and the perceived usefulness of disaster management planning activities (including interactions with Coalitions). In partnership with the American Hospital Association and America's Essential Hospitals a nationally representative survey of 2000 hospitals will be conducted to examine variation by HSSHDP status and other characteristics. Aim 2. Analyze changes (before, during, and after the COVID-19 pandemic, 2018-2023) in hospital- level quality, service levels, and finances, and in patient-level outcomes. Using secondary data sources, the study will focus on differences among HSSHDPs, and for context, compare HSSHDPs with non-HSSHDPs. Aim 3. Explore the challenges faced by HSSHDPs during the pandemic and the strategies pursued to overcome them. The study will include 12 in-depth case studies, using purposive sampling to select HSSHDPs and non-HSSHDPs with and without major effects due to COVID-19. Semi-structured interviews with stakeholders will be used to more fully understand existing structures, challenges, interactions with Coalitions, and other disaster management strategies. Aim 4. Develop prioritized policy recommendations to enhance resilience of our most critical public health systems for future disasters to protect the health of our most vulnerable populations and the facilities that serve them. A national Delphi consensus panel in conjunction with the National Academy of Science Engineering and Medicine will be conducted.

服务健康差异人群（HSSHDP）的医院系统为种族和 少数民族和其他服务不足的社区。 HSSHDP可能会经历自然的长期影响 而人造的灾难反过来可能会影响他们所服务人群的健康状况。共同 19大流行几乎影响了每个美国医疗保健系统，因此提供了独特的机会 研究大规模和长期压力源对易受伤害的资源不足系统的影响 患者人群。使用灾难管理周期的框架（缓解，准备， 反应和恢复）该项目提议对长期影响的混合方法研究 Covid-19在四个关键领域（质量，劳动力，财务和创新）的美国医院上 特别关注HSSHDP和他们所服务的健康差异人群。 该项目将是对国家灾难对HSSHDP的影响的首次重大调查。 这项严格的混合方法研究将在识别大多数和最小影响的HSSDHP中很重要 COVID-19-19大流行，并将加深对导致成功和成功因素的理解 挑战。该研究将确定可行的最佳实践和挑战，以前 在Covid-19-19大流行期间和之后。这项研究的具体目的是： 目标1。描述Covid-19对医院的长期影响以及感知到的有用性 灾难管理计划活动（包括与联盟的互动）。与 美国医院协会和美国基本医院2000年全国代表性调查 将进行医院检查HSSHDP状态和其他特征的差异。 AIM 2。分析更改（在19日大流行之前，期间和之后，2018 - 2023年） 水平质量，服务水平和财务状况以及患者水平的结果。使用辅助数据源， 这项研究将重点介绍HSSHDP之间的差异，对于上下文，将HSSHDP与非HSSHDP进行了比较。 目标3。探索大流行期间HSSHDP面临的挑战 克服它们。该研究将包括12个深入的案例研究，使用目的抽样来选择 HSSHDP和非HSSHDP，由于19岁而产生和没有重大影响。半结构化访谈 利益相关者将被用来更充分地了解现有的结构，挑战，与 联盟和其他灾难管理策略。 目标4。制定优先的政策建议，以增强我们最关键的公众的韧性 未来灾难的卫生系统，以保护我们最脆弱人群的健康和 为他们服务的设施。国家德尔夫共识小组与国家学院结合 将进行科学工程和医学。