The National Palliative Care Research Center

Curing suffering through palliative care research.


Claire K. Ankuda MD, MPH

Assistant Professor

Icahn School of Medicine at Mount Sinai

Grant Year
Grant Term
2 year
Grant Type
Junior Faculty Career Development

Project Description
Potentially Burdensome Utilization After Functional Disability

Older adults with functional disability are at heightened risk for symptom burden and death. They also often experience expensive and potentially burdensome healthcare utilization. However, outcomes after functional disability are heterogeneous and utilization patterns over time have not been clearly demonstrated. Understanding utilization patterns after functional disability is an important step to develop approaches to target interventions towards the highest risk population of older adults. My goal is to become an independent clinician-investigator assessing and informing models of care for older adults with functional decline and serious illness. In this proposal I outline a research project, mentorship strategy, and development plan to catalyze my development as an independent investigator. I plan to use novel longitudinal analysis methods to examine the experiences of the highest risk population of older adults with functional disability within the Medicare-linked National Health and Aging Trends Study. This will involve: (1) measuring the role of disability in predicting patient-centered, claims-based measures such as Emergency Department visits, transitions in care, and days at home; (2) defining the trajectories of total healthcare expenditures after incident disability using cutting-edge growth based trajectory analysis methods; and (3) assessing the clinical, demographic, socioeconomic and household factors shaping future trajectories of utilization for this population. These research aims are tightly linked with development aims to build my skills in (1) claims analysis, (2) longitudinal and group based trajectory analysis, and (3) serious illness payment policy. This work will form the basis for a K-award to further assess the patient and caregiver experience and to identifiable potentially modifiable health system factors that shape trajectories after functional disability. Ultimately, this work will inform the use of functional disability markers within care models and payment policies to improve the care of high-risk older adults.


Claire K. Ankuda, MD, MPH, is an Assistant Professor in the Department of Geriatrics and Palliative Medicine at the Icahn School of Medicine at Mount Sinai.  A Vermonter, she earned an MD from the University of Vermont and a MPH from the Harvard School of Public Health before going to the University of Washington for family medicine residency.  She was then a Robert Wood Johnson Clinical Scholar at the University of Michigan during which time she conducted a 6-month policy externship at the Center for Medicare & Medicaid Innovation.  Following this, she completed a Palliative Medicine fellowship at Mount Sinai.  Dr. Ankuda is a health services researcher who aims to assess the impact of payment policies and health systems on outcomes for seriously ill older adults and their families.