Clinical Trials Logo

Clinical Trial Summary

The project proposes to fill gaps in the understanding of disparities in healthcare and primary care provider (PCP) quality from the perspectives of adult Medicare beneficiaries with disabilities compared to those without disabilities. Studies document racial/ethnic, economic, and education-related disparities, but little is known about healthcare disparities related to disability.


Clinical Trial Description

BACKGROUND: The project proposes to fill gaps in the understanding of disparities in healthcare and primary care provider (PCP) quality from the perspectives of adult Medicare beneficiaries with disabilities compared to those without disabilities. Studies document racial/ethnic, economic, and education-related disparities, but little is known about healthcare disparities related to disability.

OBJECTIVE: The investigators' goal is to engage stakeholders as peers and partners in the development of an evidence-based Patient-Inspired Surveillance Tool for documenting variations in healthcare and PCP quality and any outcome consequences associated with these variations among people with disabilities (PWD) and people without disabilities (PWOD). The tool is intended to provide guidance on programs and policies to ameliorate disparities, improve function, and enhance autonomy in populations of people.

METHODS: The investigators will explore perceptions about the determinants of healthcare and PCP quality in partnership with stakeholders including PWD, PWOD, family of PWD, and healthcare providers in efforts to better understand underlying determinants of healthcare disparities that might be accelerating clinical deterioration. Applying population weighted data and multi-variable methods to patient information included in the Medicare Current Beneficiary Survey (MCBS), the investigators will determine the presence or absence of perceived problems across 5 healthcare and PCP quality "comparators" and (if present) the magnitude of impact on likelihood of patients' functional improvement, functional decline, institutionalization, or death referenced to no status change by 1, 2, and 3 years. A decade of data from the MCBS (on about 40,000 working age and elderly patients) will be applied to ensure adequate statistical power for comparisons. Stakeholders will help interpret the implications of findings and partner with clinician researchers in building the Tool.

PATIENT OUTCOMES: For aim 2, the outcome will be healthcare and PCP quality across 5 "quality comparators" including patients' perceptions about care coordination and quality, access barriers, technical skills of PCP, interpersonal skills of PCP, and the quality of information provided by PCP. Comparisons will be cross sectional contrasting the proportions of people at each stage of disability referenced to PWOD perceiving lower verses higher quality on each comparator. These 5 comparators will become the exposure for aims 3 and 4.

For aims 3 and 4, the outcome will include "no change" (individual remains at the same Activity of Daily Living (ADL)/Instrumental Activity of Daily Living (IADL) stage), "functional improvement" (recovery to a lower ADL/IADL stage), "functional decline" (deterioration to a higher stage of ADL/IADL limitation), "institutionalization" (long-term nursing home), or "death." Comparison will be longitudinal prediction at 1, 2, and 3 years in contrast to no change according to each comparator. ;


Study Design


Related Conditions & MeSH terms


NCT number NCT02626910
Study type Observational
Source University of Pennsylvania
Contact
Status Completed
Phase N/A
Start date August 1, 2013
Completion date July 1, 2017

See also
  Status Clinical Trial Phase
Completed NCT03305731 - Activating Behavior for Lasting Engagement After Stroke N/A
Not yet recruiting NCT05975476 - Comparison of Two Park-Based Activities on Emotional Well-Being in Adults With Mobility Impairments N/A
Completed NCT02604082 - Comparison of Three Technical Airway Clearance in Mechanical Ventilated Patients N/A
Completed NCT01472263 - Use of Pentoxifylline in Human T-lymphotropic Virus Type-1 (HTLV-1) Diseases Phase 3
Completed NCT01417585 - A Trial of a Client-centered Intervention Aiming to Improve Functioning in Daily Life After Stroke N/A
Recruiting NCT06331858 - The Effect of Adding Instrumented Hip Concentric Abductor Strengthening Exercise in Knee Osteoarthritis N/A
Completed NCT04956705 - Vitamin D and Calcium Supplementation at Danish Nursing Homes N/A
Recruiting NCT05516030 - HIFT for People With Mobility-Related Disabilities N/A
Recruiting NCT04591574 - ABC - A Post Intensive Care Anaemia Management Trial N/A
Completed NCT04562662 - Evaluation of mediVR-KAGURA Guided Therapy N/A
Terminated NCT03696082 - A Precision Rehabilitation Approach to Counteract Age-Related Cognitive Declines N/A
Completed NCT03545932 - Self-perception of Health Status and Physical Condition of Elderly People Practitioners of Hydrogymnastics N/A
Completed NCT04433962 - Investigation of the Effects of Balance Training on Balance and Functional Status Patients With Total Hip Arthroplasty N/A
Not yet recruiting NCT06264362 - Developing a Nonpharmacological Pain Intervention for Community-dwelling Older Adults With Dementia N/A
Completed NCT02926313 - The Effectiveness of Specialist Seating Provision for Nursing Home Residents N/A
Completed NCT02592265 - Measuring Consequences of Disability for Patients With Multiple Sclerosis and Caregivers on Economic Burden N/A
Completed NCT02110290 - Effects of an Adapted Ski/Snowboarding Program on Quality of Life in Children With Physical Disabilities
Active, not recruiting NCT01646632 - Exercise Intervention in Institutionalized Elderly People Phase 2
Completed NCT00164476 - Promoting Clinical Preventive Services Among Adults With Disabilities Phase 1
Completed NCT02082171 - Multidomain Intervention to Prevent Disability in Elders N/A