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.

服务健康差异人群的医院系统 (HSSHDP) 为种族和群体提供所需的服务 少数民族和其他服务不足的社区。 HSSHDP 可能会经历自然因素的长期影响 以及人为灾难，这反过来又可能影响他们所服务的人群的健康结果。新冠病毒—— 19 大流行病几乎影响了美国每一个医疗保健系统，因此提供了一个独特的机会 研究大规模和长期的压力源对为弱势群体服务的资源不足系统的影响 患者人群。使用灾害管理周期框架（减灾、备灾、 反应和恢复），该项目建议对长期影响进行混合方法研究 COVID-19 对美国医院的影响涉及四个关键领域（质量、劳动力、财务和创新），其中 特别关注 HSSHDP 及其所服务的健康差异人群。 该项目将是第一个针对国家灾难对 HSSHDP 影响的重大国家调查。 这项严格的混合方法研究对于确定受 HSSDHPS 影响最大和最小的方面具有重要意义。 COVID-19 大流行并将加深对导致成功和影响的因素的理解 挑战。该研究将确定可行的最佳实践以及 HSSHDP 运营面临的挑战， COVID-19 大流行期间和之后。本研究的具体目的是： 目标 1. 描述 COVID-19 对医院的长期影响以及人们认为的有用性 灾害管理规划活动（包括与联盟的互动）。与合作伙伴 美国医院协会和美国基本医院 2000 年进行的全国代表性调查 将根据 HSSHDP 状态和其他特征对医院进行检查。 目标 2. 分析医院内的变化（2018-2023 年 COVID-19 大流行之前、期间和之后）- 质量水平、服务水平、财务水平以及患者水平的结果。使用二手数据源， 该研究将重点关注 HSSHDP 之间的差异，并就背景情况将 HSSHDP 与非 HSSHDP 进行比较。 目标 3. 探讨 HSSHDP 在疫情期间面临的挑战以及采取的策略 去克服它们。该研究将包括 12 个深入的案例研究，利用有目的的抽样来选择 HSSHDP 和非 HSSHDP 有或没有受到 COVID-19 的重大影响。半结构化访谈 与利益相关者的合作将有助于更全面地了解现有的结构、挑战以及与利益相关者的互动 联盟和其他灾害管理策略。 目标 4. 制定优先政策建议，以增强最关键公众的抵御能力 未来灾害的卫生系统，以保护我们最脆弱人群的健康和 为他们服务的设施。与美国国家科学院联合成立的国家德尔菲共识小组 将进行科学工程和医学。