BIBLIOGRAPHY

Hold it – my patients are sicker! The importance of case mix adjustment to practitioner profiles in British Columbia

British Columbia Med J 43:328-333. Ministry of Health and Ministry Responsible for Seniors, Province of British Columbia; UBC Centre for Health Services & Policy Research, […]

Optimal pricing of employment-based health plans

Minneapolis, MN, USA: University of Minnesota (doctoral dissertation). University of Minnesota, Minneapolis, MN, USA Employer-provided health insurance is a major component of the health care […]

Selection of Medicaid beneficiaries for chronic care management programs: overview and uses of predictive modeling

Shrewsbury, MA: Center for Health Policy and Research. Center for Health Policy and Research, University of Massachusetts Medical School, Shrewsbury, MA, USA Effective use of […]

ACGs: an ambulatory care case-mix measure. Health Quality section update

Center for Health Quality Outcomes and Economic Research. Bedford, MA, USA: CHQOER Quarterly, ENRM VA Hospital. Center for Health Quality Outcomes and Economic Research, Bedford, […]

Morbidity, service utilization and health spending in Montrealers aged 65 and older in 2005-2006: an application of the Johns Hopkins “Adjusted Clinical Group” system

Montreal, QC, Canada: Montreal Health and Social Services Agency. Published in French; also have English translation. Montreal Health and Social Services Agency, Montreal, QC, Canada […]

Risk adjustment and Medicare

New York, NY, USA: Commonwealth Fund. Division of Health Policy Research and Education, Harvard University, Boston, MA, USA Almost all observers agree in principle that […]

Implementing a model for risk distribution among competing health plans

Final report. Princeton, NJ, USA: Robert Wood Johnson Foundation.

Health-based capitation risk adjustment in Minnesota public health care programs

Health Care Financ Rev 26:21-41. Gregory A. Gifford and Kevan R. Edwards are with the Minnesota Department of Health. David J. Knutson is with the […]

Facilitating equity and efficiency in Malaysian primary health care through the application of the ACG® case mix system

BMC Health Serv Res 9(Suppl 1):A7. Ministry of Health, Malaysia     Introduction: Malaysian health care is a parallel system with both public and private sectors. […]

Socioeconomic status and the use of medicines in the Ontario Public Drug Program

Canadian Public Policy 37:563-576. University of Toronto, Toronto, ON, Canada Residents of Ontario aged 65 years and older are covered by a provincially funded prescription […]

El analisis de la morbilidad y comorbilidad como instrumento para facilitar la gestion clinical y organizacion de los servicios en atencion primaria

SEMG 139:441-448. Published in Spanish. Gerencia de Atencion Primaria del Area de Salud de Tenerife, Spain No abstract

Coût de l’ordonnance des médecins généralistes: une analyse sur les données de l’EPPM

Economie Publique :239-269. Published in French. Ministère des Affaires sociales et de la Santé, Paris, France Cet article examine de manière critique la possibilité de  […]

The 2013 RHA indicators atlas

Winnipeg, MB, Canada: Manitoba Centre for Health Policy. Manitoba Centre for Health Policy, Winnipeg, MB, Canada The results in this report show clearly that the […]

Paying for primary care: the factors associated with physician self-selection into payment models

Working paper no. 2014-06. Toronto, ON, Canada: Canadian Centre for Health Economics. Canadian Centre for Health Economics, Toronto, ON, Canada In this paper we use […]

Chapter 4: Effects of multimorbidity on healthcare resource use

In: Mercer SW, Salisbury C, Fortin M, ed. ABC of multimorbidity. Chichester, UK: Wiley:12-16. Haifa University, Haifa, Israel; Johns Hopkins University, Baltimore, MD, USA OVERVIEW […]

ACG-modell kan forutsaga vilka som blir hogkonsumenter av sjukvard

Lakartidningen: Published in Swedish. Health Department, Area Monitoring and Analysis , VästraGotaland, Sweden We describe a method, which uses already existent administrative data to identify […]

Understanding geographic variation in health care costs in British Columbia

Vancouver, BC, Canada: University of British Columbia (doctoral dissertation). University of British Columbia, Vancouver, BC, Canada Amidst concerns about escalating health spending, examining variation in […]

Strategies for assessing health plan performance on chronic diseases: selecting performance indicators and applying health-based risk adjustment

Hamilton, NJ, USA: Center for Health Care Strategies. University of Maryland, Baltimore County, and Johns Hopkins Bloomberg School of Public Health, USA As Medicaid managed […]

Burden of illness in defined populations

Stockholm, Sweden: Karolinska Institute. Karolinska Institute, Stockholm, Sweden This thesis addresses possibilities of describing the burden of illness in a population by elucidating morbidity and […]

Risk assessment of military populations to predict health care cost and utilization

Final report prepared for Center for Health Care Management Studies. RTI Project No. 08490.006. Washington, DC, USA: RTI International and Boston University School of Medicine. […]

The development and testing of risk adjusters using Medicare inpatient and ambulatory data

Final report for Health Care Financing Administration contract 93-026/EE. Falls Church, VA, USA: Lewin Group. Lewin Group, Falls Church, VA, USA The Health Care Financing […]

The Adjusted Clinical Group (ACG) reporting framework

Reporting Framework Subcommittee of the Steering Committee of the Minnesota ACG Users Group. St. Paul, MN, USA: Minnesota ACG Users Group. Minnesota ACG Users Group, […]

Minimal-burden risk adjusters for the Medicare risk program

Medical College of Virginia Associated Physicians, Mathematica Policy Research. Report prepared for the Health Care Financing Review (HCFA Contract No. 17C-90366/3/01). Washington, DC, USA: Mathematica […]

Application of patient safety indicators in Manitoba: a first look.

Winnipeg, MB, Canada: Manitoba Centre for Health Policy. Manitoba Centre for Health Policy, Winnipeg, MB, Canada Although there has always been an interest in patient […]

Analysis of practice variation due to payment methods across health insurance schemes

Khon Kaen, Thailand: Khon Kaen University. There are three public insurance schemes, the non-contributory Civil Servant Medical Benefit  Scheme (CS) for government employees, pensioners and […]

Risk adjustment in a European primary care context: assessing the properties of Adjusted Clinical Groups (ACG) for predictive modeling, for special populations and using ATC pharmacy codes

Baltimore, MD, USA: Johns Hopkins University (doctoral dissertation). Risk adjustment has become an essential tool in modern health services research and management. Specifically, it can […]

Comprehensive care coordination for chronically ill adults

Chapter 5: Intervention components. In: Schraeder C, Shelton PS, ed. Chichester, UK: Wiley-Blackwell:87-126. Care coordination seeks to bridge the gap between the needs of people […]

The association between usual health care utilization and stage at diagnosis in laryngeal cancer

Kingston, ON, Canada: Queen’s University (masters thesis). Queen’s University, Kingston, ON, Canada BACKGROUND: A significant number of laryngeal cancer patients are diagnosed with advanced-stage disease. […]

Adverse selection and inertia in health insurance markets: when nudging hurts

Am Econ Rev 103:2643-2682. University of California, Berkeley, CA, USA This paper investigates consumer inertia in health insurance markets, where adverse selection is a potential […]

Physician-level variation in practice patterns in the VA healthcare system

Health Serv Outcomes Res Methodology 3:95-106. Houston Center for Quality of Care and Utilization Studies, Veterans Affairs Medical Center, Houston, TX, USA; Baylor College of […]

Clinical analytics and data management for the DNP

New York, NY, USA: Springer. Johns Hopkins Health Care, Glen Burnie, MD, USA Strong data management knowledge and skills are a requirement for every DNP. […]

Using case finding and risk stratification: a key service component for personalised care and support planning

London, UK: National Health Service. National Health Service. London, UK This handbook describes current thinking and provides practitioner insights into case finding and risk stratification […]

Population profiling in Slough CCG

Windsor, UK: NHS Slough Clinical Commissioning Group. NHS Slough Clinical Commissioning Group, Windsor, UK As our population ages and the prevalence of long term conditions […]

Editorial: Managing costs with software. Advance for Health Information Executives

Advance Newsmagazines, King of Prussia, PA, USA More than two years ago when Dave Ford took over as CEO at CareOregon in Portland, Ore., the […]

Validation and uses of the ACG-DX predictive modeling and risk adjustment tool in an Israeli HMO

Clin Med Res 8:51-52. Maccabi Healthcare Services, Tel Aviv, Israel BACKGROUND: With an ever increasing population of HMO members with chronic disease and continuing economic […]

The additional cost of chronic disease in Manitoba

Winnipeg, MB, Canada: Manitoba Centre for Health Policy. Manitoba Centre for Health Policy, University of Manitoba, Winnipeg, MB, Canada Many Manitobans have a chronic disease—indeed […]

A comparative analysis of methods of health risk assessment: final report

Cambridge, MA, USA: Harvard University School of Public Health. Harvard University School of Public Health, Cambridge, MA, USA A key component of many recent proposals […]

Implementing risk assessment and risk adjustment for people with disabilities in state programs: six case studies

Washington, DC, USA: NRH Center for Health and Disability Research. NRH Center for Health & Disability Research, Washington, DC, USA As a group, people with […]

A comparative analysis of claims-based tools for health risk assessment

Schaumburg, IL, USA: Society of Actuaries. Japanese translation published by Tokyo Gakugei University. Society of Actuaries, Schaumburg, IL, USA This Society of Actuaries research project […]

Capitation payment systems – risk factor estimation

Academia Economic Papers 28:231-261. Published in Chinese. PURPOSE: To explore risk factors that can explain individual medical expenditure. SAMPLE: Subjects included in “1996 NHI Satisfaction […]

Managing the gap: evaluating the impact of Medicaid managed care on service use and disparities in health care access

Baltimore, MD, USA: University of Maryland (doctoral dissertation). University of Maryland, Baltimore, MD, USA The National Institutes of Health (NIH) define a health disparity as […]

Identifying patients with high pharmacy consumption by using the Adjusted Clinical Groups in a primary care setting

European Neuropsychopharmacology 19:S340-S341. Badalona Serveis Assistencials SA, Directorate ofPlanning, Badalona. Barcelona, Spain BACKGROUND: Prescription drug costs are rapidly increasing in most countries. The pharmaceutical expenditure […]

Plataforma de proces de dades d’atencio primaria

Barcelona, Spain: Universitat Politecnica de Catalunya (masters thesis). Published in Catalan. Universitat Politecnica de Catalunya, Spain No abstract

Measuring the casemix of physician practices in primary-care reform models in Ontario, Canada

BMC Health Serv Res 11:A22. Institute for Clinical Evaluative Sciences, Toronto, ON, Canada INTRODUCTION: A number of different blended-payment models for primary- care delivery have […]

Patients with chronic illness in the patient-centered medical home: costs, use, quality and morbidity-based variation

Seattle, WA, USA: University of Washington (doctoral dissertation). University of Washington, Seattle, WA, USA Originally described in 1967 as a central source of a medical […]

Evaluation of the full service family practice incentive program and the practice support program: synthesis report for work completed to June 2013

Victoria, BC, Canada: Hollander Analytical Services Ltd. This report constitutes a synthesis of findings from the evaluation of the Full Service Family Practice Incentive Program […]

Kan casemix-systemer anvendes i den danske primaersektor?

Odense, Denmark: Syddansk Universitet. Published in Danish. Syddansk University, Odense, Denmark Dette arbejdspapir er udarbejdet af Forskningsenheden for Almen Praksis (FEA) og Center for Sundhedsøkonomisk […]

Copayment level and drug switching: findings for type 2 diabetes

Am J Pharm Benefits 2:412-420. University of Hawaii at Manoa, Honolulu, HI, USA OBJECTIVE: To assess the relationship between copayment level and drug switching among […]

Does increased medication use among seniors increase risk of hospitalization and emergency department visits?

Working Paper 150004. Toronto, ON, Canada: Canadian Centre for Health Economics. Canadian Centre for Health Economics, Toronto, ON, Canada Objective: to examine the extent of […]

Diagnosis and disruption: understanding guideline-consistent dementia care and patterns of transition experienced by individuals with dementia

Vancouver, BC, Canada: University of British Columbia (doctoral dissertation). University of British Columbia, Vancouver, BC, Canada Introduction: Early detection and management, as outlined in dementia […]

CareOregon: transforming the role of a Medicaid health plan from payer to partner

New York, NY, USA: Commonwealth Fund. Commonwealth Fund, New York, NY, USA CareOregon, a Portland, Oregon-based nonprofit Medicaid health plan, developed two innovative programs to […]

The knowledge of morbidity in primary care as an aid in the planning and management of the services

Semergen doi:10.1016/j.semerg.2009.12.003. Published in Spanish. Servicio Canario de la Salud, Santa Cruzde Tenerife, Spain The analysis of the morbidity and management of its knowledge is […]

Allocating funds for healthcare in Manitoba regional health authorities: a first step – population-based funding

Winnipeg, MB, Canada: Manitoba Centre for Health Policy. Manitoba Centre for Health Policy, Dept. of Community Health Sciences, Faculty of Medicine, University of Manitoba, Winnipeg, […]

Managed care holds down costs, doesn’t hurt quality

Minneapolis Star Tribune, January 3:A13. No abstract

Risk adjustment lexicon

Reporting Framework Subcommittee of the Steering Committee of the Minnesota ACG Users Group. Revised by Chad Abrams, Terry Bernhardt, Steven Foldes, Jason Wiley, May 17, […]

Quality of care for Medicaid and privately insured children in a commercial insurance plan

Richmond, VA, USA: Virginia Commonwealth University (doctoral dissertation). Virginia Commonwealth University, Richmond, VA, USA The central thesis of this study is that exposure to the […]

Risk adjustment in competitive health plan markets

In: Culyer AJ, Newhouse JP, ed. Handbook of Health Economics, Volume 1. Amsterdam, Netherlands: Elsevier Science B. V.:755-845. Erasmus University, Rotterdam, Netherlands; Boston University, Boston, […]

Equity in health, health care services use and health care financing in British Columbia, 1992 and 2002

Vancouver, BC, Canada: University of British Columbia (doctoral dissertation). University of British Columbia, Vancouver, BC, Canada The objectives of this thesis are to identify equity […]

Work limitations and their relationship with morbidity burden in employed persons with diabetes

Baltimore, MD, USA: Johns Hopkins University (doctoral dissertation). Johns Hopkins University, Baltimore, MD, USA BACKGROUND. Work limitations are functional limitations within the work context resulting […]

The application of Johns Hopkins Adjusted Clinical Group Case-mix System in AFMS

In: Cato W, Roberts WC, ed. Proceedings of the 2011 AFMS Medical Research Symposium, Volume 4. Healthcare Informatics Track. August 2-4, 2011, National Harbor, MD, […]

Morbi-mortality and use of recourses after acute coronary syndrome in a Spanish population

Revista Clinica Espanola 211:560-571. Directorate of Planning, Badalona Serveis Assistencials SA, Badalona, Spain Morbi-mortality and use of recourses after acute coronary syndrome in a Spanish […]

A population-based study of healthcare resource utilization by metastatic gastric cancer patients in Ontario

Kingston, ON, Canada: Queens University (masters theseis). Queens University, Kingston, ON, Canada BACKGROUND: Gastric cancer is the fourth most common cancer in the world. Non-curative, […]

Association between use of a specialized diagnostic assessment unit and the diagnostic interval in Ontario breast cancer patients

Kingston, ON, Canada: Queen’s University (masters thesis). Queen’s University, Kingston, ON, Canada BACKGROUND: The amount of time that it takes to get a breast cancer […]

Comorbidity and healthcare expenditure in women with osteoporosis living in the Basque Country (Spain)

J Osteoporosis Basque Institute for Healthcare Innovation, Barakaldo, Spain BACKGROUND: The aim of the study was to estimate the prevalence of depression in the population […]

Relationship between pain and quality of life – findings from the Swedish National Study on Aging and Care – Blekinge study

Scand J Pain 5:270-275. Blekinge Institute of Technology, Karlskrona, Sweden; Lund University, Lund, Sweden; Linnaeus University, Växjö, Sweden BACKGROUND AND AIMS: The influence of pain […]

MEDS-AD Waiver (MTM) Program final report

Prepared for Florida Medicaid. Tallahassee, FL, USA: College of Medicine, Florida State University. Florida State University, Tallahassee, FL, USA This report summarizes the final findings […]

Change in functional outcomes during inpatient rehabilitation for patients with hypoxic-ischemic brain injury

Arch Phys Med Rehabil 96:e18. Toronto Rehabilitation Institute, Toronto, ON, Canada Objective(s): To investigate determinants of change in functional outcomes during inpatient rehabilitation (IR) among […]

Performance of an ambulatory case-mix measurement in primary care in Spain: Ambulatory Care Groups (ACGs)

Eur J Public Health 9:27-35. Unitat d’Investigació Centre del Institut Catalá de la Salut, Barcelona, Spain BACKGROUND: Patient classification systems based on the defining of […]

ACG use in Veterans Administration in Taiwan: final report

Taipei, Taiwan: Veterans General Hospital Taipei. Published in Chinese. Department of Medical Affairs and Planning, Taipei Veterans General Hospital, Taipei City, Taiwan, ROC The goal […]

Sex differences in health status, health care use and quality of care: a population-based analysis for Manitoba’s regional health authorities

Winnipeg, MB, Canada: Manitoba Centre for Health Policy. Manitoba Centre for Health Policy, Department of Community Health Sciences, Faculty of Medicine, University of Manitoba, Winnipeg, […]

A comparison of alternative approaches to risk measurement

Final report, grant number 93-G07, Physician Payment Review Commission. Minneapolis, MN, USA: Park Nicollet Medical Foundation. Park Nicollet Medical Foundation, Minneapolis, MN, USA Under health […]

ACGs: ambulatory care groupings for case-mix categorization

Final report for grant #HS05505, National Center for Health Care Research/Health Care Technology Assessment. Baltimore, MD, USA: Johns Hopkins University. Johns Hopkins University, Baltimore, MD, […]

CYDL Project One summary report: experiences of Albertan youth 2008/2009

Child and Youth Data Laboratory. Edmonton, AB, Canada: Centre for Child, Family and Community Research. Site also has videos of presentations of report data. Centre […]

A study of population needs-based funding applied to health care and physician services in British Colulmbia

Vancouver, BC, Canada: University of British Columbia (masters thesis). University of British Columbia, Vancouver, BC, Canada The BC Ministry of Health has developed a Population […]

Evaluation of the Medicaid Value Program: health supports for consumers with chronic conditions

Hamilton, NJ, USA: Center for Health Care Strategies. Center for Health Care Strategies, Hamilton, NJ, USA The Center for Health Care Strategies’ (CHCS) Medicaid Value […]

Chapter 5: Antihypertensive adherence and drug class among Asian Pacific Americans

In: Bateman WB – Abesamis-Mendoza J – Ho-Asjoe H – ed. Praeger handbook of Asian-American health: taking notice and taking action. Santa Barbara CA USA: […]

Adherence with lipid-lowering, antihypertensive, and diabetes medications

Am J Pharm Benefits 3:165-171. Hawaii Medical Service Association, Honolulu, HI, USA OBJECTIVES: To investigate the combinations of medications patients were taking, the study examined […]

Adaptation of the categories Johns-Hopkins ACG Case-Mix System in primary healthcare: a longitudinal, retrospective claim database study

WebmedCentral ECONOMICS OF MEDICINE 2:WMC001657. Directorate of Planning, Badalona Serveis Assistencials SA, Badalona, Spain BACKGROUND: To determine the adaptation capacitating of categories case-mix adjustment (Adjusted […]

Comparing the costs and use of services in TRICARE Prime with employer sponsored insurance

Orlando, FL, USA: AcademyHealth Annual Research Meeting. NORC at the University of Chicago, Bethesda, MD, USA RESEARCH OBJECTIVE: The objectives are: to compare the cost […]

The trend of prevalence of multimorbidity and needs of out-patient health care services in rural and urban areas in Klaipeda region

Health Sci 23:173-178. Published in Lithuanian. The aim of the study: to evaluate multimorbidity dynamics, and needs of out-patient health care services in rural and […]

Predicting the Cost of Health Care Services

Abstract   Background: Case-mix systems and comorbidity indices aggregate clinical information about patients over time and are used to characterize need for health care services. […]

Evaluation of the Maryland Multi-Payer Patient Centered Medical Home Program

First Annual Report. Baltimore, MD, USA: Maryland Health Care Commission. IMPAQ International, Columbia, MD, USA The Maryland Health Care Commission (MHCC), an agency of the […]

Primärvårdens ersättnings- och styrsystem i förändring: ACG – kejsarens nya kläder?

Socialmedicinsk tidskrift Socialmedicinsk tidskrift:200-215. Published in Swedish Academy of Health and Welfare, Mälardalen University, Eskilstuna, Sweden The SALAR-project ‘Care on Equal Terms’ evaluation showed that […]

Determinants of delayed discharge from acute care among patients with hypoxic-ischemic brain injury

Arch Phys Med Rehabil 96:e15. Toronto Rehabilitation Institute, Toronto, ON, Canada Objective(s): To describe key demographic and acute care characteristics  of patients admitted with a […]

The use of drugs in Montrealers aged 65 years and older in 2005-2006

Montreal, QC, Canada: Montreal Health and Social Services Agency. Published in French; also have English translation. Montreal Health and Social Services Agency, Montreal, QC, Canada […]

Center for Health Program Development and Management, University of Maryland, Baltimore County, and Actuarial Research Corporation

A guide to implementing a health-based risk-adjusted payment system for Medicaid managed care programs. Annandale, VA, USA: Center for Health Program Development and Management, University […]

Pharmaceutical use in Manitoba: opportunities to optimize use

Winnipeg, MB, Canada: Manitoba Centre for Health Policy. Manitoba Centre for Health Policy, University of Manitoba, Winnipeg, MB, Canada This report provides a snapshot of […]

The Florida MediPass program

Chapter 4. In: Gavin NI, Farrelly MC, ed. Evaluation of Medicaid managed care programs with 1915(b) waivers. Presented to HCFA Office of R&D. Rockville, MD, […]

Assessment of Ambulatory Care Groups with comparison to existing ambulatory case-mix classification systems

Systems Research and Applications Corporation. Arlington, VA, USA: Systems Research and Applications Corporation. Systems Research and Applications Corporation, Arlington, VA, USA The Office of the […]

L’utilisation des services de sante par les Montrealais atteings de diabete, annees 2001-2002 a 2009-2010

Montreal, QC, Canada: Montreal Health and Social Services Agency. Montreal Health and Social Services Agency, Montreal, QC, Canada No abstract

Evaluation of diagnosis-based risk adjustment among specific subgroups: can existing adjusters be improved by simple modifications?

Health Serv Outcomes Res Methodology 3:57-73. Academic Technology Center, Bentley College, Waltham, MA, USA; Center for Health Quality, Outcomes and Economic Research, Veterans Administration Medical […]

Evaluation of alternative diagnosis based risk adjustment models and morbidity trajectories for application in Taiwan

Baltimore, MD, USA: Johns Hopkins University (doctoral dissertation). Department of Health Policy and Management, Johns Hopkins University, Baltimore, MD, USA OBJECTIVE: The overall goals of […]

Hospitalizations for ambulatory care sensitive conditions among persons with an intellectual disability,

Manitoba, 1999-2003. Toronto, ON, Canada: University of Toronto (doctoral dissertation). University of Toronto, Toronto, ON, Canada This thesis examines hospitalizations for ambulatory care sensitive conditions […]

Nursing home adverse events: further insight into highest risk periods

Journal of the American Medical Directors Association 12:467-474. University of Manitoba, Winnipeg, MB, Canada INTRODUCTION: Adverse events (AEs) occur frequently in nursing homes (NHs). Although […]

The feasibility of an outpatient casemix classification system based on the health insurance database in Thailand

Health Systems Research Institute and Alliances :Published in Thai. The objective of this study was to examine the feasibility of an outpatient casemix classification system […]

Comparing the costs and use of services for military care in military and civilian facilities

Orlando, FL, USA: AcademyHealth Annual Research Meeting. NORC at the University of Chicago, Bethesda, MD, USA RESEARCH OBJECTIVE: The objective is to compare the cost […]

The association between metformin therapy and mortality following breast cancer: a population-based study

Toronto, ON, Canada: University of Toronto (masters thesis). University of Toronto, Toronto, ON, Canada Metformin has been associated with a reduction in breast cancer incidence, […]

Using a health information exchange system for imaging information: patterns and predictors

AMIA Annu Symp Proc 2013:1402-1411. Weill Cornell Medical College, New York, NY, USA Health information exchange (HIE) systems may address the challenges that prevent easy […]

Children and youth with traumatic brain injury: Who uses homecare services, what do they use, and how much does it cost?

First International Conference on Pediatric Acquired Brain Injury, September 2015, Liverpool, UK. University of Toronto, Toronto, ON, Canada Objective: To determine, by sex, the predictors, […]

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