Research Proposal on "Proposal to Study Arthritis"

Research Proposal 8 pages (4057 words) Sources: 1+

[EXCERPT] . . . .

Therefore, through expanded population and demographic sampling techniques, a more precise picture of the general population could be created and more accurately illustrate the trends that are present in the population from a broader general public heath perspective that includes a more representative sample of the U.S. population (Nielson & Barratt, 2009). Such research could help researchers gain insights as to the effects of the drug restrictions and determine more precisely if the general population is experiencing the same trends equally, or if these trends impact people from low socioeconomic statuses disproportionately, which could help decision makers to draft more informed public policies (Lin, Bharel, Zhang, O'Connell & Clark, 2015).

Project Description/Narrative

Hypothesis and specific aims:

This research effort has been designed to study the effects of the restrictions placed on prescription drugs for arthritis and whether these restrictions may lead to increases in hospitalization rates of arthritis patients. It is hypothesized that lower costs related to prescription drugs for arthritis will be correlated with a decrease in the hospitalization rate for patients suffering symptoms related to arthritis. The specific aims will be to identify potential negative consequences that arise from the restrictions placed on prescriptions for arthritis patients.

Methods

Sample selection/description of primary data sources:

The methodology that will be used in the study will include a cross-sectional sample that will be used for a data analysis that will include data from a particular community within a specific time that will be scheduled (Reichenheim & Coutino, 2010). A systematic sampling will be compiled and the sample will be further restricted to individuals that are 18 years and older who are enrolled in either the Medicaid and Medicare programs and who may also be specifically interested in the potential healthcare association between osteoarthritis and rheumatoid arthritis. No prescription discount card or other prescription drug benefits will be offered and individuals will only be selected from households in which incomes are less than or equal to 100% of federal poverty level in this specific location. The study will be conducted in Irvine, TX, and will focus on the potential association between prescription drug use for arthritis and the direct and indirect healthcare costs that might be associated with Medicaid and Medicare beneficiaries that have been diagnosed with arthritis.

Data Collection:

The data will be collected and coded by healthcare outcomes which will include factors such as the number of emergency department visits, ambulatory physician visits, the length of hospital stays and total health expenditures. Both the independent and dependent variables will be compiled based on data that will be collected from the Arizona HealthQuery (ARHQ) database of medical records that includes data that represents both the public and private healthcare sectors. This data will be compiled in an estimated period that equals roughly one year from people that are enrolled in Medicaid and Medicare programs. The ARHQ includes data for services covered by Arizona Health Care Cost Containment System (AHCCCS) and Medicare and Medicaid as well as precise data outlining the fee for services agreements that are managed for the Medicare and Medicaid enrollees.

Data Analysis:

One line of investigation will be employed to calculate the total health care expenditures related to arthritis in an attempt to determine whether the restrictiveness of the prescription drug policy is related to increases in medical care and/or prescription drug spending. The total health expenditures will include the total amount of money paid by the Medicaid and Medicare for a combination of different services including emergency department visits, hospital stays, and ambulatory department visits that are used to treat arthritis within the time frame outlined in the scope of the study.

The sample of Medicare enrollees with either primary or secondary diagnosis of rheumatoid arthritis or osteoarthritis can also be used to estimate any trends that might be present for enrollees with a leading diagnostic assessment of either type 1 of the 2 conditions (Orizio, Merla, Schulz & Gelatti, 2011). Previous research efforts that have employed similar methodologies have indicated that restricted drugs were associated with 16% fewer ambulatory visits and 35% more hospitalizations for those with rheumatoid arthritis, which would roughly equate to a 61% increase in total medical and prescription drug expenditures for the patients; it also found that those with osteoarthritis restricted formularies had 23% more ambulatory visits and 71% more hospitalization (Orizio, Merla, Schulz & Gelatti, 2011).

Therefore, in the data analysis, comparisons can be made to see whether Medicaid healthcare plans and Medicare healthcare plans in this sample are consistent with previous findings. The information acquired related to the effects of the restrictions placed on prescription drugs for arthritis patients and if decisions about health care plans have an impact on the number of people being admitted to the hospital could be used by decision makers to help guide the development of more effective public policies (Orizio, Merla, Schulz & Gelatti, 2011).

Ethics Statement:

The study intends to collect data about human subjects and this data will be acquired from the Arizona Health Query. Therefore, the research will be IRB approved and subject to the same requirements for ethics that the Arizona Health Query must uphold in their data collection procedures.

Data Sharing:

The data will be collected, coded, and recorded in an anonymous form and then can be hosted on a public server so that the general public can have access to it. The scope of the proposed data collection and analysis will include an estimated 400 individuals and will be collected exclusively from the Arizona Health Query and are made available to researchers and analysts without any fees or licensing restrictions.

Proposed Timeline:

The first month of the study will be used to gather general information and find qualified research assistants which will be employed to help gather data from the database, work on the different analyses included in the study, and also help prepare the final reports. The second month will then be used to travel to different geographic regions in the U.S. and gather regional data about Medicare and Medicaid programs and policies that could be used to help delineate various factors that are relevant relative to the restrictiveness of prescription drug policies and the consequences of such policies such as the volume of people being admitted to the hospital for arthritic ailments. The third month will be used solely for the coding and preliminary analysis of the data collected and will also be used to examine the data for any trends that might be present in either the aggregate database that is compiled as well as individual trends that might emerge in that analysis of different individual regions or various combinations of regional data collections. Finally, a more detailed data analysis will be conducted using an array of different perspectives from different experts and consultants and then whatever findings are revealed through this analysis will be prepared for publication. Furthermore, various reports will be created individually and specifically customized for the various stakeholder groups that might be interested in the study and its findings. The entire study, from its concept to the publication and presentation of the findings, is estimated to take roughly 2 years from start to finish.

Proposed Budget

Budget Justification

There are senior or key positions that will be required to effectively administer the project. The project manager will be responsible for the entire duration of the project and the completion of all the phases of the project management lifecycle that include the initiation phase, planning process, execution phase, monitoring and controlling, and the project's closing as well as the presentation of the results to the relevant stakeholders. Ultimately, this professional will be entirely responsible for the successful completion, or failure, of the entire project. As a result of the responsibilities that are demanded by this position, the project manager is the highest paid member of the project team.

There are also three positions that will be filled by external contracting organizations that include a professional research consulting firm, a local web development business, and a local travel consultant. MRC was chosen as the professional consulting firm and they are located in Houston, TX. They were chosen not only for their general expertise in medical research, but also with their professional experience relative to specifically to medical record analysis, their industry experience, and their network of contacts and knowledge of the internal workings of the industry. Furthermore, the local web developer will be responsible for building a collaboration website for the team to use and also to build the website for the public that will host the data and the findings upon the completion of the project. Also, the travel agent will be able to help plan and book the trips for the team members to visit other regional locations to gather information and data at these sites. Each of these positions will be filled on a… READ MORE

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