Humana Value-Based Care Research Award

Austin J. Hilt, MPH, & Morteza Komeylian, MD

With support from Humana Inc., one of the nation’s leading health and well-being companies, the AGS awarded the inaugural Humana Value-Based Care Research Awards to Austin J. Hilt, MPH, a medical student at Northeast Ohio Medical University, and Morteza Komeylian, MD, a Clinician Fellow at the University of Texas Medical Branch at Galveston.

Selected from more than 1,000 research abstracts submitted for consideration—the AGS’s most competitive pool to-date for its Annual Scientific Meetings—work by Hilt and Dr. Komeylian exemplifies four important priorities embodied by the Humana Value-Based Care Research Award, which celebrates commitments to:

  • Enhancing experiences of care by working to raise quality and satisfaction with the health systems that make person-centered care possible; 
  • Improving the health of the overall population, especially as more Americans than ever before meet the challenges and opportunities that come with increased longevity; 
  • Reducing individual and social burdens posed by high healthcare costs, which too often prevent older people from contributing to communities; and
  • Developing new skills and expertise for the diverse health professionals who make our health, safety, and independence a reality as we age.

Working with colleagues from Division of Aging at Brigham and Women’s Hospital in Boston, Hilt explored the impact of social vulnerability on readmission rates for hospitalized older individuals. A link between the two is important for health professionals to understand, since personal relationships, social supports, social engagement, and socioeconomics all play a role in overall wellbeing as we age, though few of these characteristics have been evaluated from a clinical perspective. In their study, Hilt and his associates used a “social vulnerability index” to explore readmission rates for more than 200 people receiving in-patient (or hospital) geriatric care. Those with generally higher social vulnerability scores—evaluated based on seven clinical criteria—were more likely to be readmitted to the hospital or die compared to older people with a higher socioeconomic status or better connections to social networks and supports. But surprisingly, people with the highest social vulnerability scores also had the lowest risk of returning to the hospital or dying. In fact, patients with closer to average levels of social vulnerability were at the greatest risk of readmission or death. These findings suggest that more “average” patients, a group that can easily be overlooked, may benefit from increased attention in discharge planning. Overall, Hilt’s work holds promise for helping healthcare professionals embed social vulnerability awareness in clinical workflows, thereby connecting at-risk older adults to social interventions in geriatric care.

Dr. Komeylian’s study, “Isolated Hip Fracture Process Improvement at a Tertiary-Care Medical Center,” explores ways to improve outcomes for one of the most serious and costly challenges older adults face: hip fractures following a fall. For people recovering from such injuries, an approach that leverages coordinated care among several different professionals has shown promise for improving care, now backed by an analysis from Dr. Komeylian and his colleagues, who looked at a specific inter-professional process for improving care. Assessing markers of quality care for people at a tertiary care medical center (a health facility that provides specialist attention after someone is referred from their primary care provider or a hospital), the researchers looked at outcomes for people receiving care from a coordinated group of specially trained experts in trauma services, orthopedics, geriatrics, and anesthesiology. This team approach helped the tertiary care center increase efficiency in getting patients into surgery within 48 hours while also reducing their lengths of stay and in-hospital mortality. According to Dr. Komeylian and his team, the program they reviewed demonstrates the effectiveness of multidisciplinary collaboration and holds promise for expanding targeted interventions to further improve care.

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