# The Impact of physician and health system factors on the quality of care for persons with Alzheimer's disease and related dementias at the end of life

> **NIH NIH R01** · UNIVERSITY OF CALIFORNIA LOS ANGELES · 2024 · $302,945

## Abstract

Project Summary
Women are disproportionally affected by Alzheimer's disease and Alzheimer's disease-related dementias
(AD/ADRD) with approximately two-thirds of individuals diagnosed with this condition being women. Studies
have revealed substantial sex and gender disparities in AD/ADRD care and outcomes, with women being less
likely to receive annual blood pressure and weight monitoring, and more likely to experience delayed initiation
of anti-dementia medication than men. Despite a growing body of literature documenting sex and gender
disparities in AD/ADRD care, research on underlying causes of these disparities remains limited. Research on
healthcare in general (not focusing on AD/ADRD care) indicates that patient-physician gender concordance,
gender diversity of physicians' training environments, and health system board diversity are associated with
the care quality and outcomes. However, their impact on sex and gender disparities in AD/ADRD care has not
been investigated. The proposed study will address this important knowledge gap by analyzing the nationally-
representative data on patients, physicians, medical schools, residency programs, and health systems, that will
be developed by linking 5 nationally-representative databases (Medicare Claims Data, Doximity Physician
Data, Association of American Medical Colleges Medical School Data, American Medical Association
Residency Program Data, and American Hospital Association National Health Care Governance Survey Data).
In Aim 1, using this comprehensive database, we will investigate the effect of patient-physician gender
concordance on sex and gender disparities in AD/ADRD care and outcomes (e.g., anti-dementia medication
use, annual depression screening). In Aim 2, we will examine the effect of gender diversity in medical schools
and residency programs attended by the physician (the proportion of female students and faculty at the
medical school attended by the physician; the proportion of female residents and female patients with
AD/ADRD at residency program completed by the physician) on sex and gender disparities in AD/ADRD care
and outcomes. In Aim 3, we will investigate the effect of health system board diversity (the gender composition
of health system boards) on sex and gender disparities in AD/ADRD care and outcomes. This project will
provide a robust evidence base for policymakers to develop policy interventions (e.g., increasing female
representation in physician workforce, introducing sexual and gender sensitivity in medical education, and
promoting sex and gender diversity in health system boards) that could effectively mitigate sex and gender
disparities in AD/ADRD care. The research team consists of investigators with expertise in all relevant fields
(AD/ADRD care, geriatric care, women's health, and physician-level determinants of the quality of care) to
conduct this innovative research.

## Key facts

- **NIH application ID:** 10914371
- **Project number:** 3R01AG068633-05S1
- **Recipient organization:** UNIVERSITY OF CALIFORNIA LOS ANGELES
- **Principal Investigator:** Yusuke Tsugawa
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2024
- **Award amount:** $302,945
- **Award type:** 3
- **Project period:** 2020-09-15 → 2026-05-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10914371

## Citation

> US National Institutes of Health, RePORTER application 10914371, The Impact of physician and health system factors on the quality of care for persons with Alzheimer's disease and related dementias at the end of life (3R01AG068633-05S1). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/10914371. Licensed CC0.

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