# iCAREFOR: Interhospital Care Fragmentation in Older Adults with Dementia

> **NIH NIH K23** · EMORY UNIVERSITY · 2022 · $151,444

## Abstract

PROJECT SUMMARY
 When a patient is readmitted to a different hospital than the one they were previously
discharged from, fragmentation of care occurs. Such fragmented readmissions are associated
with a number of negative patient outcomes, including a nearly two-fold increased risk for
mortality. Preliminary analyses by Dr. Sara Turbow, the PI for this grant, have shown that a
diagnosis of Alzheimer’s disease and related dementias (ADRD) was an independent predictor
of interhospital care fragmentation. In Aim 1, she will use Medicare data to estimate the
association between inpatient fragmentation of care and either a) emergency department arrival
via an ambulance or b) coming from a post-acute care facility. We hypothesize that ambulance
use and post-acute care facility residence will contribute to the higher prevalence of interhospital
care fragmentation in older adults with ADRD. In Aim 2, Dr. Turbow will examine the association
between information sharing across hospitals and patient outcomes in older adults with ADRD
by comparing fragmented readmissions between hospitals that share data via a health
information exchange versus those that do not. In Aim 3, she will survey health professionals
and interview health system leaders to ascertain critical barriers and facilitators to information
sharing between healthcare settings. This proposal directly addresses the mission of the
National Institute on Aging and of the National Plan to Address Alzheimer’s Disease, specifically
to optimize care quality and efficiency for older adults with ADRD, and the applications of this
research have implications for dementia care and health disparities research in ADRD.
 The proposed aims will be completed under the superlative mentorship of Dr.
Mohammed K. Ali (expertise in health services research and implementation science), Dr.
Camille Vaughan (expertise in aging/geriatrics research), Dr. Molly Perkins (expert in qualitative
methods), Dr. Kimberly Rask (expert in health services research/health economics), and Dr.
Steven Culler (Medicare data expert), as well as faculty at Emory’s Goizueta Alzheimer’s
Disease Research Center. Emory University has ample resources to allow Dr. Turbow to carry
out her research aims. Her training plan is structured to include formal didactic training at Emory
and online via the UCSF Implementation Science Certification Program. The research aims and
training plan will position Dr. Turbow to become an independently funded health services and
aging researcher.

## Key facts

- **NIH application ID:** 10451540
- **Project number:** 5K23AG065505-03
- **Recipient organization:** EMORY UNIVERSITY
- **Principal Investigator:** Sara Diane Turbow
- **Activity code:** K23 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2022
- **Award amount:** $151,444
- **Award type:** 5
- **Project period:** 2020-08-15 → 2025-05-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10451540

## Citation

> US National Institutes of Health, RePORTER application 10451540, iCAREFOR: Interhospital Care Fragmentation in Older Adults with Dementia (5K23AG065505-03). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/10451540. Licensed CC0.

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