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Bibliography

Applicability of predictive risk groupers to MHS data model. Deliverable 8: interim analysis of results

Reston, VA, USA: AdvanceMed Corp. AdvanceMed Corp., Reston, VA, USA AdvanceMed Corporation, a DynCorp company, is supporting the TRICARE Management Activity (TMA) and its health […]

Risk adjustment for asthma: variations by methodology and implications for providers

Working paper: Informed Purchasing Series. Hamilton, NJ, USA: Center for Health Care Strategies. Center for Health Programs Development and Management, University of Maryland, Baltimore County, […]

From theory to application: the implementation of risk adjustment for Minnesota Medicaid

Minneapolis, MN, USA: Park Nicollet Institute, Minnesota Department of Health, Minnesota Department of Human Services. Park Nicollet Institute and Minnesota Department of Health, Minneapolis, MN, […]

Impact of continuity of care and provider factors on medication adherence in patients with hypertension

Baltimore, MD, USA: Johns Hopkins University (doctoral dissertation). Johns Hopkins University, Baltimore, MD, USA STATEMENT OF THE PROBLEM: Hypertension is one of the most common […]

Understanding approaches to case-mix assessment and case-mix adjustment

JHQ Online :W5-24 – W5-29. McKesson Medical Management Group, Newton, MA. Rising healthcare costs coupled with diminishing financial  resources are stimulating changes in the organization […]

Diabetes, gender and neighbourhood ethnicity: inequalities in healthcare resource utilization

Canadian Journal of Diabetes 33:281. Provincial Health Services Authority, Vancouver, BC, Canada AIMS: Lower utilization of medical resources by immigrants are often observed in self-reported […]

Mortalidad por cualquier causa e incidencia de enfermedad cardiovascular en hipertensos con perfil tipo Anglo-Scandinavian Cardiac Outcomes Trial en un ambito poblacional espanol

Aten Primaria 42:420-430. Published in Spanish. Dirección de Planificación, Badalona Serveis Assistencials S.A., Badalona, Barcelona, Spain OBJECTIVES: Mediterranean populations are traditionally considered to be associated […]

Development of a Medical Productivity Index for health insurance beneficiaries

Insurance Markets and Companies: Analyses and Actuarial Computations 2:7-15. University of Minnesota, Minneapolis, MN, USA In this paper, a Medical Productivity Index (MPI) is proposed […]

Des indicateurs de qualité à l’intention des professionnels et des gestionnaires des services de première ligne

Institut national d’excellence en santé et en services sociaux (INESSS). Rapport rédigé par Marie-Dominique Beaulieu, Marie‐Pascale Pomey, Brigitte Côté, Claudio Del Grande, Monia Ghorbel, Phuong […]

Social Housing in Manitoba

Winnipeg, MB, Canada: Manitoba Centre for Health Policy. Manitoba Centre for Health Policy, Winnipeg, MB, Canada The Manitoba Centre for Health Policy (MCHP) in conjunction […]

Clinical integration of the chronic patient

Enfermeria Clnica 24:35-43. Published in Spanish. Gerencia del Servicio de Salud de Castilla-La Mancha (SESCAM), Toledo, Spain Castilla-La Mancha Health Service is developing the integration […]

Predictive validity of tools used to assess the risk of unplanned admissions: a rapid review of the evidence

York, UK: University of York. University of York, York, UK CRD has developed an evidence briefing and support service tailored to the needs of commissioners […]

Physician integrated network: a second look

Winnipeg, MB, Canada: Manitoba Centre for Health Policy. Manitoba Centre for Health Policy, Winnipeg, MB, Canada This is the second report from Manitoba Centre for […]

Putting your faith in data

Commissioning Success :34-36. No abstract. Article a PDF.

Does surgical setting or wait-time incentive improve return to work following knee surgery among injured workers?

Final report to WorkSafeBC. Vancouver, BC, Canada: University of British Columbia. University of British Columbia, Vancouver, BC, Canada; University Health, Toronto, ON, Canada; University of […]

The faces of Medicaid: the complexities of caring for people with chronic illnesses and disabilities

Hamilton, NJ, USA: Center for Health Care Strategies. Center for Health Care Strategies, Hamilton, NJ, USA A complex question has persisted in our minds since […]

Employer purchasing coalitions and Medicaid: experiences with risk adjustment

New York, NY, USA: Commonwealth Fund. Commonwealth Fund, New York, NY, USA Choice among health plans increases patient satisfaction with care and enables families to […]

Clinical and economic features of categories of patients in defined populations

Stockholm, Sweden: Karolinska Institute (doctoral dissertation). Department of Clinical Services, Center for Family and Community Medicine, Karolinska Institute, Stockholm, Sweden This thesis addresses the use […]

Use predictive modeling to improve profitability under cap

National Health Information LLC. Capitation Rates and Data 9:61-65. National Health Information LLC, Atlanta, GA, USA Health plans and capitated provider organizations live or die […]

Health-based risk assessment: risk-adjusted payments and beyond

Washington, DC, USA: AcademyHealth. AcademyHealth, Washington, DC, USA A number of payers across the country, including Medicaid managed care programs, the Medicare+Choice program, some state […]

Cost benefit analysis of pharmaceutical care in a Medicaid population – from a budgetary perspective

J Managed Care Pharm 4:303-308. Nova Southeastern University, Ft. Lauderdale, FL, USA The objective was to evaluate the economic impact of Medicaid pharmaceutical care services […]

Comparing the value of three main diagnostic-based risk-adjustment systems (DBRAS)

Ottawa, ON, Canada: Canadian Health Services Research Foundation. Canadian Health Services Research Foundation, Ottawa, ON, Canada Diagnostic-Based Risk-Adjustment Systems (DBRAS) are now widely used in […]

Using pharmacy information in a decision support system to improve efficient delivery of primary health care

A study focusing on the Swedish national drug register. BMC Health Serv Res 0:A6. Ensolution, Stockholm, Sweden INTRODUCTION: The aim of the project was to […]

Utilización de los grupos clínicos ajustados en un centro de atención primaria español: estudio retrospectivo de base poblacional

Rev Panam Salud Publica 27:49-55. Published in Spanish. Dirección de Planificación, Badalona Serveis Assistencials, S.A., Barcelona, Spain OBJETIVOS. Evaluar los resultados de la aplicación del […]

Disparities in antipsychotic medication use

Vancouver, BC, Canada: University of British Columbia (masters thesis). University of British Columbia, Vancouver, BC, Canada OBJECTIVES: To examine ethnic and income-related disparities in the […]

Pilot projects carried out in Lithuania and Latvia: quality indicators for high quality PHC performance

ImPrim Report #3. Karlskrona, Sweden: ImPrim. Klaipeda University, Klaipeda, Lithuania Quality improvement of primary health care is the topic requiring attention from all stakeholders  throughout […]

Who is in our hospitals … and why?

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

Kronik: Datafangst fra nyt system kan anvendes både administrativt og sundhedspolitisk

Ugeskrift for Laeger 176:380-381. Published in Danish. Syddansk University, Odense, Denmark

Federal disaster declarations and denials: analyzing spatial equity in the implementation of the Stafford Act

Tampa, FL, USA: University of South Florida (doctoral dissertation). University of South Florida, Tampa, FL, USA Federal disaster declarations are authorized by the president under […]

VG primarvard i for hallande till riksrevisionens rapport “primaryvardens styrning – efter behov eller efterfragan?”

Vanersborg, Sweden: Vastra Gotalandsregionen. Published in Swedish. Vastra Gotalandsregionen, Vanersborg, Sweden

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

Final report. Columbia, MD: IMPAQ International. IMPAQ International, Columbia, MD, USA; Johns Hopkins University, Baltimore, MD, USA; University of Maryland, Baltimore, MD, USA The Maryland […]

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 […]