Prognostic Significance of Insufficient ADL Help on Health Outcomes/Utilization

ADL 帮助不足对健康结果/利用率的预后意义

基本信息

批准号：
7887568
负责人：
LAURA P. SANDS
金额：
$ 33.68万
依托单位：
PURDUE UNIVERSITY
依托单位国家：
美国
项目类别：
财政年份：
2010
资助国家：
美国
起止时间：
2010-04-01 至 2014-03-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/7887568
关键词：
Activities of Daily Living Acute Admission activity Age Aging Bathing Behavioral Model Caring Cessation of life Clinical Community Surveys Complement Cross-Sectional Studies Data Data Analyses Dementia Disabled Persons Eating Elderly Event Expenditure Future Gender Goals Health Health Resources Health Services Health Status Healthcare Hospitalization Hospitals Individual Institutes Link Long-Term Care Longitudinal Studies Measures Medicare Medicare claim Methods Needs Assessment Nursing Homes Outcome Patient Self-Report Patients Pattern Persons Policy Maker Population Public Health Reporting Research Research Personnel Resources Risk Sterile coverings Surveys Time Variant Vital Statistics base clinically significant design disability health care service utilization high risk mortality patient oriented population based prevent prognostic public health relevance racial and ethnic response social

项目摘要

DESCRIPTION (provided by applicant): Approximately 20% of older adults report they do not have sufficient care for their activity of daily living (ADL) disabilities. Prior research suggests that subjective assessments of insufficient care are associated with negative health events such as hospitalization, nursing home placement, and mortality. However, it is not known whether subjective assessments provide prognostic information about health outcomes and health care utilization that is not already provided by traditionally measured demographic, resource, health, and functional risks for these outcomes. The specific aims of our proposal are to determine: (1) the unique prognostic significance of subjective assessments of insufficient ADL care on health outcomes and health care utilization; (2) whether there are age, gender and racial/ethnic variations in the prognostic significance of subjective assessments of insufficient ADL care for subsequent health outcomes and health care utilization, and (3) the extent to which type and amount of ADL care received explains the association between subjective assessments of insufficient personal ADL and subsequent health outcomes and utilization. We will conduct this study using data from 5,995 ADL disabled individuals from the 1994, 1999, and 2004 National Long Term Care Survey community assessments. Health outcomes and health care utilization patterns will be determined from linked Medicare claims and vital statistics data. The National Long Term Care Survey is a population-based survey with extensive self-reported information about ADL functioning, help received, health status, and resources for obtaining health care. The results will inform whether subjective assessments of insufficient ADL help complement traditional assessments of need currently used by clinicians, policy makers, and researchers. The results will also inform the public health significance of subjective assessments of insufficient ADL care by assessing whether they are independently associated with excess health burden in a population that is already at high risk for poor health outcomes and high health care utilization. PUBLIC HEALTH RELEVANCE: Approximately 20% of older adults report they do not have sufficient care for their ADL disabilities. The proposed research will determine the unique prognostic value of subjective assessments of insufficient help on future health outcomes and health care utilization. The results of the proposed research will inform whether subjective assessments of insufficient ADL care complement traditional assessments of need currently used by clinicians, policy makers, and researchers.

描述（由申请人提供）：大约20％的老年人报告说，他们对日常生活（ADL）残疾的活动没有足够的照顾。先前的研究表明，对护理不足的主观评估与住院，疗养院安置和死亡率等负面健康事件有关。但是，尚不清楚主观评估是否提供有关健康结果和医疗保健利用的预后信息，这些信息尚未由传统测量的人口统计，资源，健康和功能风险提供这些结果。我们建议的具体目的是确定：（1）主观评估ADL护理对健康结果和医疗保健利用的不足的独特预后意义；（2）是否存在年龄，性别和种族/种族差异，即对随后的健康成果和医疗保健利用的主观评估的预后意义，以及（3）获得的ADL护理的类型和数量的程度解释了对个人ADL和后续健康的主观评估的结合，并解释了ADL护理的多大程度和数量。我们将使用来自1994年，1999年和2004年国家长期护理调查社区评估的5,995名ADL残疾人个人的数据进行这项研究。健康成果和医疗保健利用模式将由链接的Medicare索赔和重要统计数据确定。国家长期护理调查是一项基于人群的调查，其中包含有关ADL功能，帮助接收，健康状况和获得医疗保健资源的广泛自我报告的信息。结果将告知ADL不足的主观评估是否有助于补充临床医生，政策制定者和研究人员当前使用的传统评估。结果还将通过评估他们是否与已经处于不良健康结果和高医疗保健利用率的高风险的人群中的过多健康负担来评估ADL护理不足的主观评估的公共健康意义。公共卫生相关性：大约20％的老年人报告说，他们对ADL残疾没有足够的护理。拟议的研究将确定对未来健康结果和医疗保健利用的帮助不足的主观评估的独特预后价值。拟议研究的结果将告知ADL护理不足的主观评估是否补充了临床医生，政策制定者和研究人员当前使用的传统评估。