Abstract

The purpose of this career development award is to support Dr. Zingmond in establishing a career in improving the quality of geriatric care. Dr. Zingmond's overall goal is to examine the medical and nursing processes of care among older individuals receiving institutional and home-based long-term care and in turn, how these processes of care can be related to primary and secondary measures of outcome. This process-oriented approach extends prior work in quality of long-term care that has focused primarily on outcomes-based performance measures. Yet, outcomes do not pinpoint what to do and a lack of adverse events does not necessarily indicate good care. Evaluation of long-term care quality is still in its infancy in part due to the poorer general health of these patients, the complex nature of the goals and outcomes of care, and the lack of routinely collected measures of patient health, care received, or outcomes relevant to long-term care. It is important to understand (1) how patient and provider characteristics affect patient care, (2) how care processes can be measured and related with patient outcomes, and (3) which processes are effective in reducing undesired outcomes across the spectrum of long-term care, from home-based care to nursing home care. The proposed research has 3 aims that will form the basis for Dr. Zingmond's future work. In summary, the specific aims of this mentored career development award are to: 1. Adapt consensus expert quality indicators of processes of care for individuals receiving (a) homebased or (b) institutional long-term care to administrative data; And Characterize the quality of long-term care delivered to patients in California. 2. Examine the impact of process of care on maintaining function, preventing over-utilization, and decreasing mortality among nursing home recipients. 3. Examine the impact of process of care on maintaining independence and function, preventing over-utilization, and decreasing mortality among home care recipients.

  Funding Agency

Agency
National Institute of Health (NIH)
Institute
National Institute on Aging (NIA)
Type
Clinical Investigator Award (CIA) (K08)
Project #
5K08AG023024-04
Application #
7260449
Study Section
National Institute on Aging Initial Review Group (NIA)
Program Officer
Stahl, Sidney M
Project Start
2004-09-01
Project End
2009-06-30
Budget Start
2007-07-01
Budget End
2008-06-30
Support Year
4
Fiscal Year
2007
Total Cost
$116,370
Indirect Cost

  Institution

Name
University of California Los Angeles
Department
Internal Medicine/Medicine
Type
Schools of Medicine
DUNS #
092530369
City
Los Angeles
State
CA
Country
United States
Zip Code
90095

  Publications

Livhits, Masha; Gibbons, Melinda Maggard; de Virgilio, Christian et al. (2011) Coronary revascularization after myocardial infarction can reduce risks of noncardiac surgery. J Am Coll Surg 212:1018-26
Zingmond, David S; Ettner, Susan L; Wilber, Kathleen H et al. (2011) Association of claims-based quality of care measures with outcomes among community-dwelling vulnerable elders. Med Care 49:553-9
Zingmond, David S; Saliba, Debra; Wilber, Kathleen H et al. (2009) Measuring the quality of care provided to dually enrolled Medicare and Medicaid beneficiaries living in nursing homes. Med Care 47:536-44
Aranda, Michelle A; McGory, Marcia; Sekeris, Evan et al. (2008) Do racial/ethnic disparities exist in the utilization of high-volume surgeons for women with ovarian cancer? Gynecol Oncol 111:166-72
Justice, Amy C; Zingmond, David S; Gordon, Kirsha S et al. (2008) Drug toxicity, HIV progression, or comorbidity of aging: does tipranavir use increase the risk of intracranial hemorrhage? Clin Infect Dis 47:1226-30
Zingmond, David S; Wilber, Kathleen H; Maclean, Catherine H et al. (2007) Measuring the quality of care provided to community dwelling vulnerable elders dually enrolled in Medicare and Medicaid. Med Care 45:931-8
Zingmond, David S; Ettner, Susan L; Cunningham, William E (2007) The impact of managed care on access to highly active antiretroviral therapy and on outcomes among Medicaid beneficiaries with AIDS. Med Care Res Rev 64:66-82
Zingmond, D S; Soohoo, N F; Silverman, S L (2006) The role of socioeconomic status on hip fracture. Osteoporos Int 17:1562-8
Liu, Jerome H; Zingmond, David S; McGory, Marcia L et al. (2006) Disparities in the utilization of high-volume hospitals for complex surgery. JAMA 296:1973-80
Birbeck, Gretchen L; Zingmond, David S; Cui, Xinping et al. (2006) Multispecialty stroke services in California hospitals are associated with reduced mortality. Neurology 66:1527-32

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