Treatment of Displaced, Low Income Children with Chronic Conditions

流离失所、低收入慢性病儿童的治疗

基本信息

批准号：
8680635
负责人：
Troy Quast
金额：
$ 7.76万
依托单位：
SAM HOUSTON STATE UNIVERSITY
依托单位国家：
美国
项目类别：
财政年份：
2014
资助国家：
美国
起止时间：
2014-06-01 至 2015-05-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/8680635
关键词：
Accident and Emergency department Affect African American Am 80 Asthma Attention deficit hyperactivity disorder Caring Child Child Care Child health care Chronic Control Groups Data Destinations Diabetes Mellitus Diabetic Ketoacidosis Diagnosis Disadvantaged Disasters Drug Utilization Emergency Situation Enrollment Event Feedback Future Goals Grant Health Health Insurance Health Personnel Healthcare Hospitalization Household Hurricane Income Individual Inpatients Institutes Intervention Investigation Louisiana Low income Medicaid Medical Mental Health Minority Natural Disasters Obesity Outpatients Paper Patient Self-Report Pharmaceutical Preparations Policies Population Prevalence Psychologist Publishing Qualifying Relative (related person)Reporting Research Retinal Rice Risk Sampling School-Age Population Services Simulate Social Workers Surveys Symptoms Testing Texas To specify Universities Visit Vulnerable Populations Weather adverse outcome behavioral health demographics diabetic emotional trauma gulf coast health care service utilization health economics high risk improved insight low socioeconomic status model design programs public health relevance socioeconomics waiver

项目摘要

DESCRIPTION (provided by applicant): Over 1.5 million people evacuated the U.S. Gulf Coast following Hurricane Katrina (Groen and Polivka, 2007) and over 250,000 were estimated to have continued to reside in Texas nearly one year later (Texas HHS, 2006). Not only were these evacuees exposed to physical and emotional trauma, but many were from vulnerable populations and of low socio-economic status that further worsened their condition. Roughly 80% of all individuals displaced to Texas following Katrina were African American, while 60% came from households whose income was less than $20,000 per year (Texas HHSC, 2006). Children were especially vulnerable, with many missing health provider visits (Rath et al., 2007) and reporting a new onset of mental health symptoms following Katrina (Roberts, 2010). This goal of this proposal is to analyze the diagnoses and treatment of selected chronic conditions for Displaced Louisiana Children (DLCs) from low socio-economic backgrounds following Hurricane Katrina. The analysis will employ individual-level administrative data to examine the health care utilization of the roughly 30,000 DLCs enrolled in TexKat, the temporary emergency Medicaid waiver program for Katrina evacuees in Texas. The use of these data represents a potential improvement over the vast majority of existing post-disaster studies which typically employ survey data. The investigation will focus on healthcare for three chronic conditions: asthma, mental health, and diabetes. The analysis will focus on encounter rates in outpatient, emergency department, and inpatient settings as well as prescription rates for treatment medications. A difference-in-differences estimation strategy will be employed to identify changes due to displacement. Changes in utilization by DLCs before and after displacement will be compared to changes in utilization by non-displaced children. The analysis is expected to indicate that displacement was very disruptive to DLCs with chronic conditions (Rath et al., 2007). The project will provide critical information to federal, state and local agencies planning care for low-income children following disasters. The analyses of diagnoses and health care use both immediately following displacement and in the following months will provide insight into the health care needs for conditions known to be exacerbated by discontinuous medical care. By determining the services obtained by these children, our findings will assist evacuation destinations to more efficiently prepare for an influx of evacuees. Finally, policymakers may be able to use our findings to improve future Medicaid emergency waivers.

描述（由申请人提供）：飓风卡特里娜飓风（Groen and Polivka，2007年），超过150万人撤离了美国墨西哥湾沿岸，估计将近一年后继续居住在德克萨斯州（德克萨斯州HHS，2006年）。这些撤离者不仅遭受了身体和情感创伤，而且许多疏散者来自脆弱的人群和社会经济低下的地位，这进一步加剧了他们的状况。卡特里娜飓风之后，所有流离失所的人中，大约有80％是非裔美国人，而60％的人来自每年收入不到20,000美元的家庭（德克萨斯州HHSC，2006年）。儿童特别容易受到伤害，许多缺少的健康提供者就诊（Rath等，2007），并报告了卡特里娜飓风后的新精神健康症状（Roberts，2010年）。该提案的这个目标是分析卡特里娜飓风飓风后，来自低社会经济背景的路易斯安那州流离失所儿童（DLC）的诊断和治疗。该分析将采用个人级别的行政数据来检查Texkat招收的大约30,000个DLC的医疗保健利用，这是德克萨斯州卡特里娜飓风撤离者的临时紧急医疗补助计划。这些数据的使用代表了与通常采用调查数据的绝大多数现有灾后研究的潜在改进。调查将针对三种慢性疾病的医疗保健：哮喘，心理健康和糖尿病。该分析将集中在门诊，急诊科和住院环境以及治疗药物的处方率上。将采用差异性估计策略来确定由于位移而引起的变化。 DLC在位移前后的利用情况的变化将与未放置的儿童的利用变化进行比较。预计该分析将表明位移对具有慢性条件的DLC非常破坏（Rath等，2007）。该项目将为灾难后的低收入儿童计划护理的联邦，州和地方机构提供关键信息。诊断和医疗保健在流离失所之后和接下来的几个月中的分析都将深入了解已知因不连续的医疗保健而加剧已知状况的医疗需求。通过确定这些孩子获得的服务，我们的发现将有助于疏散目的地，以更有效地准备涌入疏散者。最后，决策者可能能够利用我们的发现来改善未来的医疗补助紧急豁免。