Understanding Diabetic Eye Disease in the Underserved Using Health Data Exchange

使用健康数据交换了解服务不足的地区的糖尿病眼病

基本信息

批准号：
8928622
负责人：
DUSTIN D. FRENCH
金额：
$ 18.93万
依托单位：
NORTHWESTERN UNIVERSITY AT CHICAGO
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：
2014-09-30 至 2017-08-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/8928622
关键词：
Academic Medical Centers Accounting Adult African American Age Area Blindness Blood Vessels Caring Centers for Disease Control and Prevention (U.S.)Chicago Cities Clinical Clinical Data Collaborations Communities Community Health Services Comprehensive Health Care Country County Hospitals Data Databases Demographic Factors Detection Diabetes Mellitus Diabetic Retinopathy Diagnosis Disease Epidemiology Extravasation Eye Eye diseases Faculty Federally Qualified Health Center Funding Future General Population Geographic Locations Goals Health Healthcare Healthcare Systems Hemorrhage Hispanics Incidence Individual Infusion procedures Institution Insurance Intervention Lead Liquid substance Location Low Income Population Low income Medical Medical center Medicine Minority Modeling National Eye Institute Ophthalmic examination and evaluation Ophthalmologist Ophthalmology Optometrist Patient Care Patients Persons Population Populations at Risk Prevalence Public Health Reporting Research Resources Retina Safety Services Severity of illness Site Strategic Planning Swelling System Techniques Testing Time Underrepresented Minority Uninsured United States Universities Veterans Vision Disorders Vision research base cooking cost effective data exchange diabetic diabetic patient disorder prevention health data health disparity health information technology innovation insight low socioeconomic status macula metropolitan new growth prevent programs repository safety net screening socioeconomics surgical service tool

项目摘要

DESCRIPTION (provided by applicant): The overall objective of this proposal is identify and compare Federally Qualified Health Centers (FQHC) eye care screening and treatment for diabetic retinopathy while controlling for an array of socio-economic, demographic and other related factors. Diabetes is the leading cause of blindness among United States (US) adults 40 years and older. Little is known about the prevalence of diabetic retinopathy in the growing US minority, low-income, and uninsured population. Chicago is the third most populous city in the US and comprises 2.7 million people within the city limits, and approximately 10 million in the metropolitan area. It includes multiple world class medical centers, over 70 distinct communities and most segregated areas associated with some of the largest health disparities in the country. The FQHCs are community-based organizations that provide standardized comprehensive care services to persons of all ages, regardless of their ability to pay, and are a critical component o the health care safety net. Many FQHC patients are minorities, do not have insurance, and would otherwise lack access to basic medical care. Providing insight into screening, diagnosis, and treatment (if any) will help to identify areas with greatest need for immediate intervention. The highly innovative Chicago Health Information Technology Regional Extension Center (CHITREC) is an existing database and offers the opportunity to track individual patients (over 2 million in the city of Chicago) across the fragmented health care system to better understand diabetic eye disease, screening, and treatments in the underserved and minorities. Our aims seek to identify all patients in CHITREC with a diagnosis of diabetes and classify them into three groups (non-FQHC utilization group, FQHC utilization without the presence of an ophthalmologist or optometrist, and FQHC utilization with the presence of an ophthalmologist or optometrist) and assess the difference in the rates of annual eye exams, disease detection, and treatment among these three groups. Aim 1 will estimate the number of diabetics with an annual eye care exam and Aim 2 will estimate the diabetic retinopathy detection, treatment rate and time to treatment. We will use descriptive techniques and regression models to study utilization and treatments accounting for the site and location, socio-economic, and demographic factors. This proposal allows for the strategic planning with analyses aimed at identifying the areas with the greatest need for the planned placement and infusion of additional ophthalmologists and resources directed at ameliorating the identified health disparities. Subsequently we shall test the use of non-mydratic cameras as an equivalence trial as a long-term cost effective screening strategy for the underserved patients identified and analyzed.

描述（由申请人提供）：该提案的总体目标是确定和比较联邦合格健康中心 (FQHC) 的眼部护理筛查和糖尿病视网膜病变治疗，同时控制一系列社会经济、人口和其他相关因素。糖尿病是美国 40 岁及以上成年人失明的主要原因。人们对糖尿病视网膜病变在不断增长的美国少数族裔、低收入和未投保人群中的患病率知之甚少。芝加哥是美国人口第三大城市，市区内有 270 万人口，大都市区约有 1000 万人口。它包括多个世界一流的医疗中心、70 多个不同的社区以及与该国一些最大的健康差距相关的大多数隔离区域。 FQHC 是基于社区的组织，为所有年龄段的人（无论其支付能力如何）提供标准化的综合护理服务，并且是医疗保健安全网的重要组成部分。许多 FQHC 患者都是少数民族，没有保险，否则将无法获得基本医疗服务。深入了解筛查、诊断和治疗（如果有）将有助于确定最需要立即干预的领域。高度创新的芝加哥健康信息技术区域推广中心 (CHITREC) 是一个现有数据库，提供了在分散的医疗保健系统中跟踪个体患者（芝加哥市超过 200 万）的机会，以更好地了解糖尿病眼病、筛查、以及服务不足和少数族裔的治疗。我们的目标是识别 CHITREC 中所有诊断为糖尿病的患者，并将其分为三组（非 FQHC 使用组、在没有眼科医生或验光师在场的情况下使用 FQHC 以及在有眼科医生或验光师在场的情况下使用 FQHC）并评估这三组之间年度眼科检查、疾病检测和治疗率的差异。目标 1 将估算每年进行眼保健检查的糖尿病患者数量，目标 2 将估算糖尿病视网膜病变的检出率、治疗率和治疗时间。我们将使用描述性技术和回归模型来研究考虑场地和位置、社会经济和人口因素的利用和处理方法。该提案允许进行战略规划和分析，旨在确定最需要计划安置和注入更多眼科医生和资源的领域，以改善已确定的健康差距。随后，我们将测试使用非散瞳相机作为等效试验，作为对识别和分析的服务不足的患者的长期成本有效的筛查策略。