The purpose of this proposed career development award is to support Dr. Nancy Pandhi, a family physician, in establishing a health services research program centered on effective clinical practice redesign for vulnerable older adults. This award will facilitate Dr. Pandhi's transition to independence as a health services researcher. The proposed training program contains specific benchmarks towards the achievement of six core competencies (statistics and study design, responsible conduct of research, scientific writing, teaching and presentation, leadership/management, and excellence in research) required for success as an independent researcher. The University of Wisconsin-Madison offers an ideal environment for the proposed work as it provides access to accomplished researchers with a proven track record of mentoring physician-scientists and extensive resources to support the proposed work.
The specific aims of the proposed project are: 1)To determine if continuity of care with an individual physician has an effect over and above continuity with a site on health care, health outcomes and costs for older adults, 2) To characterize vulnerability using a resource-based framework and then determine if this approach improves our understanding of how continuity with a physician and site affects older adults'health outcomes, and 3) To determine the effect of distinct aspects of continuity of care with a physician (e.g. trust) and site on older adults'health care and health outcomes. Dr. Pandhi will achieve these aims by performing primary data collection on aspects of continuity of care. She also will analyze multiple waves of previously collected data from the Wisconsin Longitudinal Survey (WLS), taking full advantage of the over fifty years of longitudinal data available for analysis of vulnerability. She will analyze health care costs by linking the WLS to Medicare claims data. The long-term goal of this research is to develop and implement a redesigned medical home with optimal continuity of care supporting vulnerable older adults'health. Dr. Pandhi's proposed research directly addresses NIA's goals of "developing] strategies to improve the interaction of older people with the health system" and for "understanding] health differences and health inequities among older adults."

Public Health Relevance

The proposed focus on vulnerability and which older adults benefit most from continuity will provide information essential to developing practice structures that effectively provide care for older adults most at risk for negative outcomes. The results from the proposed research will have implications for physician practices as they seek to redesign themselves into an effective medical home.

Agency
National Institute of Health (NIH)
Institute
National Institute on Aging (NIA)
Type
Clinical Investigator Award (CIA) (K08)
Project #
5K08AG029527-04
Application #
8236956
Study Section
National Institute on Aging Initial Review Group (NIA)
Program Officer
Haaga, John G
Project Start
2009-04-01
Project End
2014-03-31
Budget Start
2012-04-01
Budget End
2013-03-31
Support Year
4
Fiscal Year
2012
Total Cost
$133,785
Indirect Cost
$9,910
Name
University of Wisconsin Madison
Department
Family Medicine
Type
Schools of Medicine
DUNS #
161202122
City
Madison
State
WI
Country
United States
Zip Code
53715
Koslov, Steven; Trowbridge, Elizabeth; Kamnetz, Sandra et al. (2016) Across the divide: "Primary care departments working together to redesign care to achieve the Triple Aim". Healthc (Amst) 4:200-6
Ho, Aaron K; Bartels, Christie M; Thorpe, Carolyn T et al. (2016) Achieving Weight Loss and Hypertension Control Among Obese Adults: A US Multidisciplinary Group Practice Observational Study. Am J Hypertens 29:984-91
Pandhi, Nancy; Schumacher, Jessica R; Thorpe, Carolyn T et al. (2016) Cross-sectional study examining whether the extent of first-contact access to primary care differentially benefits those with certain personalities to receive preventive services. BMJ Open 6:e009738
Trowbridge, Elizabeth; Bartels, Christie M; Koslov, Steven et al. (2015) Development and Impact of a Novel Academic Primary Care Compensation Model. J Gen Intern Med 30:1865-70
Kraft, Sally; Carayon, Pascale; Weiss, Jennifer et al. (2015) A simple framework for complex system improvement. Am J Med Qual 30:223-31
Ho, Aaron K; Thorpe, Carolyn T; Pandhi, Nancy et al. (2015) Association of anxiety and depression with hypertension control: a US multidisciplinary group practice observational study. J Hypertens 33:2215-22
Fondow, Meghan; Pandhi, Nancy; Ricco, Jason et al. (2015) Visit Patterns for Severe Mental Illness with Implementation of Integrated Care: A Pilot Retrospective Cohort Study. AIMS Public Health 2:821-831
Kraft, Sally; Strutz, Elizabeth; Kay, Lawrence et al. (2015) Strange Bedfellows: A Local Insurer/Physician Practice Partnership to Fund Innovation. J Healthc Qual 37:298-310
Kamnetz, Sandra; Marquez, Byron; Aeschlimann, Ramonda et al. (2015) Are waiting rooms Passé? A pilot study of patient self-rooming. J Ambul Care Manage 38:25-8
Johnson, Heather M; Olson, Andrea G; LaMantia, Jamie N et al. (2015) Documented lifestyle education among young adults with incident hypertension. J Gen Intern Med 30:556-64

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