Did Covid and the Transition to Telehealth Change Person-Reported Outcomes for Home and Community Based Care Recipients With and Without Alzheimer's Disease and its Related Dementias?

新冠疫情和向远程医疗的转变是否改变了患有或不患有阿尔茨海默病及其相关痴呆症的家庭和社区护理接受者的个人报告结果？

• 批准号: 10863580
• 负责人: Eric Jutkowitz
• 金额: $ 31.12万
• 依托单位: UNIVERSITY OF MINNESOTA
• 依托单位国家: 美国
• 财政年份: 2020
• 资助国家: 美国
• 起止时间: 2020-09-30 至 2024-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10863580
• 关键词: Address; Adult; Affect; Aging; Alzheimer' s Disease; Alzheimer' s disease related dementia; American; Assisted Living Facilities; COVID-19 pandemic; Caregiver support; Caregivers; Caring; Case Manager; Collaborations; Communities; Complex; Data; Day Care; Dementia; Education; Elderly; Family; Family Caregiver; Funding; Goals; Health Services Research; Healthcare Systems; Home; Home Nursing Care; Human; Individual; Institution; Internet; Interview; Left; Location; Marketing; Measures; Medicaid; Medical; Modeling; Motor Skills; Nursing Homes; Outcome; Parents; Persons; Recommendation; Reporting; Research; Research Institute; Sampling; Self Care; Services; Structure; Surveys; Telephone; Translating; care delivery; care recipients; care systems; community based care; community based service; design; disability; experience; improved; interest; pandemic disease; pandemic impact; person centered; post-pandemic; pre-pandemic; satisfaction; service providers; telehealth; virtual; virtual delivery; virtual healthcare

Providing high-quality home and community-based services (HCBS) for the millions of Americans living with Alzheimer's disease and related dementias (AD/ADRD) and their caregivers is a national priority. HCBS, often funded by Medicaid as an alternative to nursing homes, are preferred by individuals and their families. However, the COVID-19 pandemic disrupted HCBS, leading to temporary closures and a shift to virtual care. During the pandemic, HCBS providers had to adapt their services, temporarily eliminating some or permanently closing. States allowed the shift to virtual care, but individuals with AD/ADRD have complex medical conditions that may be challenging to address virtually. This disruption likely left consumers, especially those with AD/ADRD, with unmet needs. To understand the effects of the pandemic on HCBS use, unmet needs, and person-reported outcomes, our study aims to examine changes in HCBS used vs desired during the pandemic, including the use of virtual care. Data from the National Core Indicators-Aging and Disabilities (NCI-AD) Adult Consumer Survey will be analyzed, comparing pre-pandemic and pandemic periods. NCI-AD measures HCBS outcomes from consumers' perspectives and includes questions about experiences during the pandemic. The study has three specific aims: Aim 1A: Determine the change in used and desired HCBS by consumers with and without AD/ADRD before and during the COVID-19 pandemic. Aim 1B: Identify whether the use of virtual care moderates the differences between used vs desired HCBS during the pandemic for people with and without AD/ADRD. Aim 2A: Determine the change in HCBS person-reported outcomes for consumers with and without AD/ADRD before and during the COVID-19 pandemic. Aim 2B: Identify whether the use of virtual care moderates the differences between HCBS outcomes during the pandemic for consumers with and without AD/ADRD. Aim 3: Examine barriers and facilitators to HCBS virtual care implementation that could impact person- reported outcomes. The impact of this research is significant as it aligns with national recommendations to improve HCBS for AD/ADRD and will inform the viability of virtual care as a model for delivering HCBS. This is crucial given the growing interest in virtual care to address challenges in the post- pandemic era and the ongoing staffing issues in the healthcare system.

为数百万人提供高质量的家庭和社区服务 (HCBS) 患有阿尔茨海默病和相关痴呆症 (AD/ADRD) 的美国人及其 照顾者是国家的优先事项。 HCBS，通常由医疗补助计划资助，作为护理的替代方案 家庭，是个人及其家庭的首选。然而，新冠肺炎 (COVID-19) 大流行 HCBS 受到干扰，导致暂时关闭并转向虚拟护理。疫情期间， HCBS 提供商必须调整他们的服务，暂时取消一些或永久取消 关闭。各州允许转向虚拟护理，但 AD/ADRD 患者有复杂的情况 虚拟地解决可能具有挑战性的医疗状况。这种破坏可能会留下 需求未得到满足的消费者，尤其是患有 AD/ADRD 的消费者。要了解的影响 HCBS 使用、未满足的需求和个人报告的结果的流行病，我们的研究旨在 检查大流行期间使用的 HCBS 与所需的变化，包括使用虚拟 关心。数据来自国家核心指标 - 老龄化和残疾 (NCI-AD) 成人消费者 将对调查进行分析，比较大流行前和大流行期间。 NCI-AD 措施 HCBS 从消费者的角度得出结果，包括有关体验的问题 疫情期间。该研究有三个具体目标： 目标 1A：确定消费者使用和期望的 HCBS 变化 在 COVID-19 大流行之前和期间没有 AD/ADRD。 目标 1B：确定虚拟护理的使用是否会缓和二手护理与二手护理之间的差异 在大流行期间，患有和没有 AD/ADRD 的人都需要 HCBS。 目标 2A：确定 HCBS 个人报告结果的变化 在 COVID-19 大流行之前和期间没有 AD/ADRD。 目标 2B：确定虚拟护理的使用是否会缓和 HCBS 之间的差异 患有和没有 AD/ADRD 的消费者在大流行期间的结果。 目标 3：检查 HCBS 虚拟护理实施的障碍和促进因素 可能会影响个人报告的结果。 这项研究的影响是重大的，因为它与国家建议相一致 改进针对 AD/ADRD 的 HCBS，并将告知虚拟护理作为交付模型的可行性 HCBS。鉴于人们对虚拟护理的兴趣日益浓厚，以应对后疫情时代的挑战，这一点至关重要。 大流行时代和医疗保健系统中持续存在的人员配备问题。