ARTICLES

The ACG System’s Applicability to Pediatric Populations

The following published studies applied the ACG System to pediatric populations. They use the ACG System to measure child health, to examine health care resource use and to gain insight into risk factors associated with repeat tests

Exploring the Johns Hopkins Aggregated Diagnosis Groups in Administrative Data as a Measure of Child Health

This study explored the utility of the Johns Hopkins Aggregated Diagnostic Groups (ADGs) as a noncategorical measure of child health in administrative health data. Canadian administrative health records for the province of British Columbia were used to examine the prevalence of specific ADG groupings, including those labeled “major” and/or “chronic,” and other prevalent child health conditions such as asthma, injuries, and psychosocial conditions. Associations with measures of health care service use (physician visits, hospital admissions, and medication use), and socio-demographic characteristics were examined.

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Effect of Attribution Length on the Use and Cost of Health Care for a Pediatric Medicaid Accountable Care Organization

Using the ACG System to measure relative healthcare resource use, researchers Eric W. Christensen, PhD and Nathaniel R. Payne, MD examined the effectiveness of a pediatric accountable care organization (ACO). Their study explored the relationship among attribution, resource use, and cost within a pediatric Medicaid population. Attribution served as a proxy for exposure to the ACO’s consistent primary care and was shown to be correlated with decreases in the use of inpatient care resources and spending, particularly among children with multiple chronic conditions.

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Do pediatric patients who receive care across multiple health systems have higher levels of repeat testing?

Researchers Andrew J. Knighton, PhD, CPA, Nathaniel R. Payne, MD, and Stuart Speedie, PhD at Intermountain Healthcare in Salt Lake City Utah sought to identify the risk factors associated with repeat tests in a pediatric population and the impact of using multiple health systems.  Using the ACG system they characterized repeat testing in a pediatric population of 8,760 children with 1-25 test claims over a 1-year period. A population-based retrospective cross-sectional design was used to examine initial and repeat test instances, defined as a second test following an initial test of the same type for the same patient. As would be expected, repeat test instances per patient were significantly higher when patients received care from more than one health system. As health information technology improves and health systems can more easily and readily share test results, the incidence and risk of repeat tests should decrease.

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