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Douglas Barthold, PhD

Faculty Starter Grant in Value Assessment and Health Outcomes Research, 2021 University of Washington

The Role of Mild Cognitive Impairment and Alzheimer’s Disease and Related Dementias (ADRD) in the Utilization of High- and Low-Value Health Care


Utilization of low-value (LV) care and under-utilization of high-value (HV) care is a major problem for older adults. Cognitive impairment (CI), including both mild cognitive impairment (MCI) and Alzheimer’s disease and related dementias (ADRD), is prevalent for older adults and likely affects HV and LV utilization. Patient harm and unnecessary costs of LV replacing HV care could be especially high and widespread in this vulnerable subpopulation, but these relationships have not been studied. The Centers for Medicare and Medicaid Services (CMS) has called for value promotion, but policies cannot be adequately targeted and implemented without understanding the aforementioned relationships. Therefore, we propose to close this gap by identifying the association between CI and utilization of LV and HV care. Results will depict trajectories of utilization of relevant services for individuals at different stages of CI and inform policies to improve patient welfare and promote healthy aging.

The Research Starter Grant from the PhRMA Foundation was a critical boost to important research on the value of care for people with cognitive impairment. This support has allowed me to accelerate my research program in this area and grow as a leader in studying the connection between health policies and the chronic conditions that define healthy aging.

David Barthold