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Causes and Consequences of Healthcare Inefficiency in Alzheimer’s Disease and Related Dementias

Award Number: P01AG019783
ORGANIZATION: NATIONAL INSTITUTE ON AGING
OPDIV: NIH
AWARD CLASS: DISCRETIONARY
AWARD ACTIVITY TYPE: SCIENTIFIC/HEALTH RESEARCH (INCLUDES SURVEYS)
PERIOD OF PERFORMANCE START DATE: 08/01/2001
PERIOD OF PERFORMANCE END DATE: 07/31/2028

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Causes and Consequences of Healthcare Inefficiency in Alzheimer’s Disease and Related Dementias - Motivated by soaring spending and stagnating life expectancy, the first 20 years of this Program Project Grant (PPG) has focused on the causes and consequences of healthcare efficiency in the U.S. This work has advanced fundamental scientific knowledge regarding sources of inefficiency and has motivated significant changes in healthcare policy and delivery for millions of Americans. This competitive renewal responds to the NIA’s prioritization of Alzheimer’s disease and related dementia (ADRD)-related research by shifting the focus of this PPG to inefficiency in healthcare services and delivery for persons with ADRD. Recent PPG research showed excess mortality among older adults with ADRD, especially for people living in nursing homes. Differences in care delivery for patients with and without ADRD – and between subgroups of patients with ADRD – run the gamut from modifiable risks that contribute to development of ADRD, initial diagnosis and referral, ongoing treatment and support, and throughout later stages, including end-of-life care. Conceptually, the drivers of individual health outcomes will be documented among persons with ADRD from the social ecological perspective which recognizes nested ‘systems’ that interact with one another (individual, interpersonal, organizational, structural, community, and policy). This PPG renewal, therefore, proposes projects focusing on each concentric circle of this model and their interactions. Project 1 will explore state-level policy heterogeneity and its influence on access to home and community-based services for nursing home eligible adults with ADRD. Project 2 will test the hypothesis that having resident service coordinators for adults who live in affordable senior housing decreases adverse health care service use and increases home and community-based service use for low- income residents with ADRD. Project 3 will explore trends in the quality of primary care for people with ADRD and to identify modifiable policy-, system- and practice-level factors that contribute to better outcomes. Finally, Project 4 will develop a novel measure of provider diagnostic test ordering in the acute care setting and explore the impact of diagnosis on the trajectory of patients with ADRD. Projects achieve synergy by using the social ecological model to examine how interactions among the key variables examined in each project could operate together to improve outcomes and reduce healthcare inefficiency, and by relying on shared administrative, data and analysis, and methodology cores.


Issue Date FY	Funding FY	Legal Entity Name	Legal Entity Address	Legal Entity City	Legal Entity State	Legal Entity Zip Code	Legal Entity COUNTY	Legal Entity COUNTRY	Assistance Listing	Award Code	Budget Year	Action Date	Action Type	Action Amount

Issue Date FY: 2026 ( Subtotal = $0 )
2026	2025	TRUSTEES OF DARTMOUTH COLLEGE	7 LEBANON ST	HANOVER	NH	03755	GRAFTON	USA	Aging Research	000	23	1/23/2026	NON-COMPETING CONTINUATION	$0
														Subtotal = $0

Issue Date FY: 2025 ( Subtotal = $3,149,542 )
2025	2025	TRUSTEES OF DARTMOUTH COLLEGE	7 LEBANON ST	HANOVER	NH	03755	GRAFTON	USA	Aging Research	000	23	8/26/2025	NON-COMPETING CONTINUATION	$3,149,542
														Subtotal = $3,149,542

Issue Date FY: 2024 ( Subtotal = $3,251,295 )
2024	2024	TRUSTEES OF DARTMOUTH COLLEGE	7 LEBANON ST	HANOVER	NH	03755	GRAFTON	USA	Aging Research	003	22	8/26/2024	NON-COMPETING CONTINUATION	$3,251,295
2024	2023	TRUSTEES OF DARTMOUTH COLLEGE	7 LEBANON ST	HANOVER	NH	03755	GRAFTON	USA	Aging Research	002	21	3/19/2024	COMPETING CONTINUATION	$637,744
2024	2022	TRUSTEES OF DARTMOUTH COLLEGE	7 LEBANON ST	HANOVER	NH	03755	GRAFTON	USA	Aging Research	000	20	3/19/2024	NON-COMPETING CONTINUATION	-$594,374
2024	2022	TRUSTEES OF DARTMOUTH COLLEGE	7 LEBANON ST	HANOVER	NH	03755	GRAFTON	USA	Aging Research	001	20	3/19/2024	SUPPLEMENT FOR EXPANSION	-$43,370
														Subtotal = $3,251,295

Issue Date FY: 2023 ( Subtotal = $3,343,572 )
2023	2023	TRUSTEES OF DARTMOUTH COLLEGE	7 LEBANON ST	HANOVER	NH	03755	GRAFTON	USA	Aging Research	001	21	8/3/2023	COMPETING CONTINUATION	$3,343,572
2023	2022	TRUSTEES OF DARTMOUTH COLLEGE	7 LEBANON ST	HANOVER	NH	03755	GRAFTON	USA	Aging Research	000	20	7/26/2023	NON-COMPETING CONTINUATION	$0
														Subtotal = $3,343,572

Issue Date FY: 2022 ( Subtotal = $2,544,313 )
2022	2022	TRUSTEES OF DARTMOUTH COLLEGE	7 LEBANON ST	HANOVER	NH	03755	GRAFTON	USA	Aging Research	002	20	6/1/2022	NON-COMPETING CONTINUATION	$237,130
2022	2022	TRUSTEES OF DARTMOUTH COLLEGE	6001 PARKHURST HALL STE 207	HANOVER	NH	03755	GRAFTON	USA	Aging Research	000	20	2/22/2022	NON-COMPETING CONTINUATION	$2,134,155
2022	2022	TRUSTEES OF DARTMOUTH COLLEGE	6001 PARKHURST HALL STE 207	HANOVER	NH	03755	GRAFTON	USA	Aging Research	001	20	2/25/2022	SUPPLEMENT FOR EXPANSION	$173,028
														Subtotal = $2,544,313

Issue Date FY: 2021 ( Subtotal = $2,395,557 )
2021	2021	TRUSTEES OF DARTMOUTH COLLEGE	6001 PARKHURST HALL STE 207	HANOVER	NH	03755	GRAFTON	USA	Aging Research	003	19	8/20/2021	NON-COMPETING CONTINUATION	$0
2021	2021	TRUSTEES OF DARTMOUTH COLLEGE	6001 PARKHURST HALL STE 207	HANOVER	NH	03755	GRAFTON	USA	Aging Research	001	19	6/17/2021	NON-COMPETING CONTINUATION	$2,395,557
2021	2021	TRUSTEES OF DARTMOUTH COLLEGE	6001 PARKHURST HALL STE 207	HANOVER	NH	03755	GRAFTON	USA	Aging Research	002	19	6/29/2021	NON-COMPETING CONTINUATION	$0
2021	2020	TRUSTEES OF DARTMOUTH COLLEGE	1 HINMAN DARTMOUTH COLLEGE	HANOVER	NH	03755	GRAFTON	USA	Aging Research	000	18	2/1/2021	NON-COMPETING CONTINUATION	$0
														Subtotal = $2,395,557

Issue Date FY: 2020 ( Subtotal = $2,759,608 )
2020	2020	TRUSTEES OF DARTMOUTH COLLEGE	1 HINMAN DARTMOUTH COLLEGE	HANOVER	NH	03755	GRAFTON	USA	Aging Research	004	18	9/4/2020	SUPPLEMENT FOR EXPANSION	$0
2020	2020	TRUSTEES OF DARTMOUTH COLLEGE	1 HINMAN DARTMOUTH COLLEGE	HANOVER	NH	03755	GRAFTON	USA	Aging Research	003	18	9/4/2020	NON-COMPETING CONTINUATION	$0
2020	2020	TRUSTEES OF DARTMOUTH COLLEGE	1 HINMAN DARTMOUTH COLLEGE	HANOVER	NH	03755	GRAFTON	USA	Aging Research	000	18	4/6/2020	NON-COMPETING CONTINUATION	$2,422,044
2020	2020	TRUSTEES OF DARTMOUTH COLLEGE	1 HINMAN DARTMOUTH COLLEGE	HANOVER	NH	03755	GRAFTON	USA	Aging Research	001	18	4/7/2020	SUPPLEMENT FOR EXPANSION	$337,564
2020	2019	TRUSTEES OF DARTMOUTH COLLEGE	1 HINMAN DARTMOUTH COLLEGE	HANOVER	NH	03755	GRAFTON	USA	Aging Research	002	17	4/22/2020	SUPPLEMENT FOR EXPANSION	$0
														Subtotal = $2,759,608

Issue Date FY: 2019 ( Subtotal = $2,485,902 )
2019	2019	TRUSTEES OF DARTMOUTH COLLEGE	1 HINMAN DARTMOUTH COLLEGE	HANOVER	NH	03755	GRAFTON	USA	Aging Research	003	17	9/17/2019	SUPPLEMENT FOR EXPANSION	$39,978
2019	2019	TRUSTEES OF DARTMOUTH COLLEGE	1 HINMAN DARTMOUTH COLLEGE	HANOVER	NH	03755	GRAFTON	USA	Aging Research	002	17	3/1/2019	NON-COMPETING CONTINUATION	$2,445,924
2019	2019	TRUSTEES OF DARTMOUTH COLLEGE	1 HINMAN DARTMOUTH COLLEGE	HANOVER	NH	03755	GRAFTON	USA	Aging Research	005	17	9/24/2019	NON-COMPETING CONTINUATION	$0
2019	2019	TRUSTEES OF DARTMOUTH COLLEGE	1 HINMAN DARTMOUTH COLLEGE	HANOVER	NH	03755	GRAFTON	USA	Aging Research	004	17	9/23/2019	SUPPLEMENT FOR EXPANSION	$0
2019	2018	TRUSTEES OF DARTMOUTH COLLEGE	1 HINMAN DARTMOUTH COLLEGE	HANOVER	NH	03755	GRAFTON	USA	Aging Research	001	16	12/11/2018	COMPETING CONTINUATION	$803,044
2019	2017	TRUSTEES OF DARTMOUTH COLLEGE	1 HINMAN DARTMOUTH COLLEGE	HANOVER	NH	03755	GRAFTON	USA	Aging Research	000	15	12/11/2018	NON-COMPETING CONTINUATION	-$803,044
														Subtotal = $2,485,902

Issue Date FY: 2018 ( Subtotal = $2,507,115 )
2018	2018	TRUSTEES OF DARTMOUTH COLLEGE	1 HINMAN DARTMOUTH COLLEGE	HANOVER	NH	03755	GRAFTON	USA	Aging Research	001	16	5/1/2018	COMPETING CONTINUATION	$2,507,115
2018	2017	TRUSTEES OF DARTMOUTH COLLEGE	1 HINMAN DARTMOUTH COLLEGE	HANOVER	NH	03755	GRAFTON	USA	Aging Research	000	15	4/27/2018	NON-COMPETING CONTINUATION	$0
														Subtotal = $2,507,115

Issue Date FY: 2017 ( Subtotal = $2,020,565 )
2017	2017	TRUSTEES OF DARTMOUTH COLLEGE	1 HINMAN DARTMOUTH COLLEGE	HANOVER	NH	03755	GRAFTON	USA	Aging Research	000	15	12/14/2016	NON-COMPETING CONTINUATION	$1,818,509
2017	2017	TRUSTEES OF DARTMOUTH COLLEGE	1 HINMAN DARTMOUTH COLLEGE	HANOVER	NH	03755	GRAFTON	USA	Aging Research	001	15	6/19/2017	NON-COMPETING CONTINUATION	$202,056
														Subtotal = $2,020,565

Issue Date FY: 2016 ( Subtotal = $1,978,451 )
2016	2016	DARTMOUTH COLLEGE	11 ROPE FERRY ROAD, #6210	HANOVER	NH	03755	GRAFTON	USA	Aging Research	000	14	12/18/2015	EXTENSION WITH OR WITHOUT FUNDS	$1,780,606
2016	2016	DARTMOUTH COLLEGE	11 ROPE FERRY ROAD, #6210	HANOVER	NH	03755	GRAFTON	USA	Aging Research	001	14	2/22/2016	EXTENSION WITH OR WITHOUT FUNDS	$197,845
														Subtotal = $1,978,451

Issue Date FY: 2015 ( Subtotal = $1,901,605 )
2015	2015	DARTMOUTH COLLEGE	11 ROPE FERRY ROAD, #6210	HANOVER	NH	03755	GRAFTON	USA	Aging Research	000	13	3/6/2015	NON-COMPETING CONTINUATION	$1,901,605
														Subtotal = $1,901,605

Issue Date FY: 2014 ( Subtotal = $1,968,112 )
2014	2014	DARTMOUTH COLLEGE	11 ROPE FERRY ROAD, #6210	HANOVER	NH	03755	GRAFTON	USA	Aging Research	000	12	11/22/2013	NON-COMPETING CONTINUATION	$1,771,300
2014	2014	DARTMOUTH COLLEGE	11 ROPE FERRY ROAD, #6210	HANOVER	NH	03755	GRAFTON	USA	Aging Research	001	12	2/14/2014	NON-COMPETING CONTINUATION	$196,812
														Subtotal = $1,968,112

Issue Date FY: 2013 ( Subtotal = $2,030,460 ) (Continued on the next page)
2013	2013	DARTMOUTH COLLEGE	11 ROPE FERRY ROAD, #6210	HANOVER	NH	03755	GRAFTON	USA	Aging Research	000	11	11/30/2012	COMPETING CONTINUATION	$2,030,460
Grand Total All Awards = $46,529,065

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Causes and Consequences of Healthcare Inefficiency in Alzheimer’s Disease and Related Dementias

Award Number: P01AG019783

ORGANIZATION: NATIONAL INSTITUTE ON AGING

OPDIV: NIH

AWARD CLASS: DISCRETIONARY

AWARD ACTIVITY TYPE: SCIENTIFIC/HEALTH RESEARCH (INCLUDES SURVEYS)

PERIOD OF PERFORMANCE START DATE: 08/01/2001

PERIOD OF PERFORMANCE END DATE: 07/31/2028

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