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Save the date! ACG System User Conference October 26-28, 2025

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Parenchymal hyperdensity on C-arm CT images after endovascular therapy for acute ischaemic stroke predicts a poor prognosis

ABSTRACT   AIM To investigate whether hyperdense areas (HDAs) observed after endovascular treatment on multisection computed tomography (CT) are related to outcome. MATERIALS AND METHODS Data on […]

Emergency Department Use: Common Presenting Issues and Continuity of Care for Individuals With and Without Intellectual and Developmental Disabilities

Abstract This population-based cohort study examined the relationship between level of continuity of primary care and subsequent emergency department (ED) visits for adults with (n = 66,484) […]

Prediction Accuracy With Electronic Medical Records Versus Administrative Claims

Abstract Objective:  The objective of this study was to evaluate the incremental predictive power of electronic medical record (EMR) data, relative to the information available […]

Population segmentation based on healthcare needs: a systematic review

Abstract Background Healthcare needs-based population segmentation is a promising approach for enabling the development and evaluation of integrated healthcare service models that meet healthcare needs. […]

Incidence of Hospitalizations and Emergency Department Visits for Herpes Zoster in Immunocompromised and Immunocompetent Adults in Ontario, Canada, 2002-2016

Abstract BACKGROUND Immunocompromised adults are at increased risk of herpes zoster (HZ) infection and related complications. We aimed to assess the incidence of hospital-attended HZ […]

Association Between Dysphagia and Inpatient Outcomes Across Frailty Level Among Patients ≥ 50 Years of Age

Abstract Frail patients may have heightened risk of dysphagia, a potentially modifiable health factor. Our aim is to examine whether the relationship between dysphagia and […]

Multimorbidity as a predictor of health service utilization in primary care: a registry-based study of the Catalan population

Abstract Background Multimorbidity is highly relevant for both service commissioning and clinical decision-making. Optimization of variables assessing multimorbidity in order to enhance chronic care management […]

Looking across health and healthcare outcomes for people with intellectual and developmental disabilities and psychiatric disorders: population-based longitudinal study

Abstract Background Intellectual and developmental disabilities (IDDs) and psychiatric disorders frequently co-occur. Although each has been associated with negative outcomes, their combined effect has rarely […]

Trends in prevalence of chronic disease and multimorbidity in Ontario, Canada

Abstract BACKGROUND New case-mix tools from the Canadian Institute for Health Information offer a novel way of exploring the prevalence of chronic disease and multimorbidity […]

Assessing the Population-Level Correlation of Medication Regimen Complexity and Adherence Indices Using Electronic Health Records and Insurance Claims

Abstract BACKGROUND Nonadherence to medication regimens can lead to adverse health care outcomes and increasing costs. OBJECTIVES To (a) assess the level of medication complexity […]

Direct cost of Parkinson’s disease in a health system with high judicialization: evidence from Colombia

Abstract Objective To estimate all-claims-all-conditions expenditures paid for by health plans for patients suffering from Parkinson´s disease (PD). Methods Using administrative claims data from two […]

Partial nephrectomy in frail patients: Benefits of robot-assisted surgery

Abstract Background To compare the effect of robot-assisted (RAPN) vs. open (OPN) partial nephrectomy on short-term postoperative outcomes and total hospital charges in frail patients […]

Controller Medication Use and Exacerbations for Children and Adults With Asthma in High-Deductible Health Plans

Abstract Importance High-deductible health plans (HDHPs) are increasingly common and associated with decreased medication use in some adult populations. How children are affected is less […]

How long does it take patients to find a new primary care physician when theirs retires: a population-based, longitudinal study

Abstract Background The retirement of a family physician can represent a challenge in accessibility and continuity of care for patients. In this population-based, longitudinal cohort […]

High prevalence of comorbidities at diagnosis in immigrants with multiple sclerosis

Abstract Background Multiple sclerosis (MS) has been associated with certain comorbidities in general population studies, but it is unknown how comorbidity may affect immigrants with […]

Primary Care Continuity andWait Times to Receiving Breast Cancer Chemotherapy: A Population-Based Retrospective Cohort Study Using CanIMPACT Data

Abstract Background Wait times to chemotherapy are associated with morbidity and mortality in breast cancer patients; however, it is unclear how primary care physician (PCP) continuity […]

Small steps, strong shield: directly measured, moderate physical activity in 65 361 adults is associated with significant protective effects from severe COVID-19 outcomes

Abstract Objective To determine the association between directly measured physical activity and hospitalisation, intensive care unit (ICU) admission, ventilation and mortality rates in patients with […]

Matching Special Olympics registration data with administrative health databases: Feasibility and health status differences in children and youth with IDD

Abstract Background Children and youth with intellectual and developmental disabilities (IDD) experience health disparities. What is unknown is if data collected from children and youth […]

Association Between Frailty, 30-day Unplanned Readmission and Mortality After Hospitalization for Heart Failure: Results From the Nationwide Readmissions Database

Abstract Objectives: This study examined how frailty in traditional risk-adjusted models could improve the predictability of unplanned 30-day readmission and mortality among heart failure patients. […]

Medicare telehealth utilization by Rural Health Clinics and Federally Qualified Health Centers prior to and during the COVID-19 pandemic

Abstract Purpose To address the extent to which Federally Qualified Health Centers (FQHCs) and independent and provider-based Rural Health Clinics (RHCs) were using telehealth prior […]

Effect of periodic health exam on provider management of preventive services

Abstract Rationale and objective To evaluate the relationship between receipt of annual physicals and the receipt of provider recommendation for preventive services, during a period […]

Using Additional Data Sets

This webinar explores the use of data sets from other Health and Social Care providers with the ACG system. In particular, it will focus on […]

Inter-Relationship Between Frailty & Multimorbidity

Presented by: Alan Thompson, MSc
Director of User Support, ACG System

Whilst it is true that resource use increases with an increasing degree of frailty, this presentation will demonstrate that not all frail patients are high cost and not all high cost patients are frail.

The excess medical cost and health problems of family members of persons diagnosed with alcohol or drug problems

Med Care 45:116-122. Division of Research, Kaiser Permanente Northern California, Oakland, CA, USA BACKGROUND: Having a family member with substance use problems affects family functioning, […]

Is socioeconomic status associated with utilization of health care services in a single-payer universal health care system?

Int J Equity Health 13:115. Ben-Gurion University, Beer Sheva, Israel; Clalit Health Services, Tel Aviv, Israel OBJECTIVES: To assess an association of Socio-economic status with […]

Validation of 2 new measures of continuity of care based on year-to-year follow-up with known providers of health care

Ann Fam Med 12:559-567. Montreal Health and Social Services Agency, Montreal, QC, Canada PURPOSE: In a primary care context favoring group practices, we assessed the […]

The healthy migrant effect in primary care

Gac Sanit 29:15-20. Aragón Health Sciences Institute (IACS), Zaragoza, Spain; University of Zaragoza, Zaragoza, Spain; Miguel Servet University Hospital, Zaragoza, Spain; Carlos III Health Institute, […]

Medication oversupply in patients with diabetes

Res Social Adm Pharm 11:382-400. Veterans Affairs Pittsburgh Healthcare System, Pittsburgh, PA, USA; University of Pittsburgh, PA, USA; University of Wisconsin, Madison, WI, USA; Pharmacy […]

Prognostic factors in metastatic gastric cancer: results of a population-based, retrospective cohort study in Ontario

Gastric Cancer 19:150-159. Department of Surgery, Maimonides Medical Center, Brooklyn, NY, USA BACKGROUND: Stage IV gastric cancer is lethal, and little population-based research on prognostic […]

The temporal risk of heart failure associated with adjuvant trastuzumab in breast cancer patients: a population study

J Natl Cancer Inst 108:10. University of Toronto, Toronto, ON, Canada; St. Michael’s Hospital, Toronto, ON, Canada; Institute for Clinical Evaluative Sciences, Toronto, ON, Canada; […]

The origin of variation in primary care process and outcome indicators: patients, professionals, centers, and health districts

Medicine 94:e1314. Centro de Salud de Astrabudua (Primary Health Care Center of Astrabudua), Osakidetza (Basque Health Service), Erandio (Bizkaia), Spain; Primary Care Research Unit-Bizkaia, Osakidetza, […]

Characteristics of physicians and patients who join team-based primary care practices: evidence from Quebec’s Family Medicine Groups

Health Policy 116:264-272. McGill University, Montreal, QC, Canada; Direction de la santé publique de l’Agence de la Santé et des services sociaux de Montréal, Montreal, […]

Adjusted Clinical Groups Method (ACG) to allocate resources according to the disease burden of each health center

Santelices C E, Muñoz P F, Muñiz P, Rojas J. BACKGROUND: Health care must be provided with strong primary health care models, emphasizing prevention and a […]

Determining the morbidity profile, health-service utilization and health-provider efficiency in the Rejang River Basin, Sarawak, based on TPC® data and the Johns Hopkins ACG® System

BMC Health Serv Res 10:A8. Ministry of Health, Malaysia; Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA Introduction: The study focused on the […]

Validating the Johns Hopkins ACG Case-Mix System of the elderly in Swedish primary health care

BMC Public Health 6:171. Blekinge Institute for Research & Development, Karlshamn, Sweden BACKGROUND: Individual based measures for comorbidity are of increasing importance for planning and […]

Use of diagnosis-based risk adjustment models to predict individual health care expenditure under the National Health Insurance system in Taiwan

J Formos Med Assoc 104:883-890. Graduate Institute of Health Care Organization Administration, College of Public Health, National Taiwan University, Taipei, Taiwan. BACKGROUND AND PURPOSE: Diagnostic […]

Risk adjustment using administrative data-based and survey-derived methods for explaining physician utilization

Med Care 48:175-182. Institute for Clinical Evaluative Sciences, Toronto, ON, Canada OBJECTIVES: The objective of this study was to evaluate an administrative data-based risk adjustment […]

An in-depth assessment of a diagnosis-based risk adjustment model based on national health insurance claims: the application of the Johns Hopkins Adjusted Clinical Group case-mix system in Taiwan

BMC Med 8:7. Department of Health Policy & Management, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA BACKGROUND: Diagnosis-based risk adjustment is […]

Predicting healthcare costs in a population of Veterans Affairs beneficiaries using diagnosis-based risk adjustment and self-reported health status

Med Care 42:1027-1035. Houston Center for Quality of Care and Utilization Studies, Health Services Research and Development Service, Michael E. DeBakey Veterans Affairs Medical Center, […]

Evaluation of guideline-concordant care for bipolar disorder among privately insured youth

Prim Care Companion J Clin Psychiatry 12:PCC.09m00837. Health Services Research Department, Institute of Psychiatry, King’s College London, London, UK OBJECTIVE: To describe and quantify the […]

Applying population-based case mix adjustment in managed care: the Johns Hopkins Ambulatory Care Group system

Manag Care Q 2:21-34. CSC Healthcare Systems, Inc., Malden, MA, USA When analyzing medical utilization or other health care-related measurements across provider panels, case mix […]

In search of the perfect comorbidity measure for use with administrative claims data: does it exist?

Med Care 44:745-753. Department of Family Medicine, University of Washington, Seattle, WA, USA BACKGROUND: Numerous measures of comorbidity have been developed for health services research […]

The development of Ambulatory Care Groups in primary care

Rev Neurol 29:667-669. Published in Spanish. Fundació Jordi Gol i Gurina, Barcelona, España INTRODUCTION: Ambulatory care groups (ACG) are a system of classification for patients […]

Comparison of private for-profit with private community-governed not-for-profit primary care services in New Zealand

J Health Serv Res Policy 9 Suppl 2:17-22. Department of Public Health, Wellington School of Medicine and Health Sciences, Wellington, New Zealand OBJECTIVE: To compare […]

Costs vs quality in different types of primary care settings

JAMA 272:1903-1908. Department of Health Policy and Management, School of Hygiene and Public Health, Johns Hopkins University, Baltimore, MD, USA OBJECTIVE: To determine the relationship […]

The validity of claims-based risk estimation in underinsured populations

Am J Manag Care 18:e468-e476. Institute for Health and Disability Policy Studies, University of Kansas, Lawrence, KS OBJECTIVES: To demonstrate a threat to validity in […]

The post-fracture care gap among Canadian First Nations peoples: a retrospective cohort study

Osteoporos Int 23:929-936. Department of Medicine, University of Manitoba, 409 Tache Avenue, Winnipeg, MB, Canada Despite targeted attempts to reduce post-fracture care gaps, we hypothesized […]

Taking health status into account when setting capitation rates: a comparison of risk-adjustment methods

JAMA 276:1316-1321. Health Research Center, Institute for Research and Education, HealthSystem Minnesota, Minneapolis, MN, USA OBJECTIVE: To compare performance of different health status measures for […]

Cardiology workforce: a shortage, not a surplus

Health Aff W4:64-66. Mayo Clinic College of Medicine, Rochester, MN, USA The United States faces a serious shortage of cardiologists as our population ages and […]

Adjusted Clinical Groups use as a measure of the referrals efficiency from primary care to specialized in Spain

Eur J Public Health 17:657-663. Planning Management, Badalona Serveis Assistencials, SA, Badalona, Barcelona, Spain BACKGROUND: To determine the referral rate (RR) per centre, its main […]

Medicaid managed care payment rates in 1998

Health Aff 18:217-227. Urban Institute, Washington, DC, USA This paper reports on a new survey of state Medicaid managed care payment rates. We collected rate […]

Chronic care improvement in primary care: evaluation of an integrated pay-for-performance and practice-based care coordination program among elderly patients with diabetes

Health Serv Res 45:1763-1782. Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Johns Hopkins Healthcare LLC, Glen Burnie, MD, USA OBJECTIVE: […]

Implementation of electronic medical records: effect on the provision of preventive services in a pay-for-performance environment

Can Fam Physician 57:e381-e389. Department of Family and Community Medicine, University of Toronto, ON, Canada OBJECTIVE: To study the effect of electronic medical record (EMR) […]

Estimation of chronic co-morbidity on health costs in elderly patients with neurological disorders

Rev Peru Med Exp Salud Publica 28:564-565. Published in Spanish. Directorate of Planning, Badalona Serveis Assistencials SA, Badalona, Spain Sr. Editor. El envejecimiento progresivo de […]

Medical care costs associated with traumatic brain injury over the full spectrum of disease: a controlled population-based study

J Neurotrauma 29:2038-2049. Mayo Clinic, Rochester, MN, USA Data on traumatic brain injury (TBI) economic outcomes are limited. We used Rochester Epidemiology Project (REP) resources […]

The performance of administrative and self-reported measures for risk adjustment of Veterans Affairs expenditures

Health Serv Res 40:887-904. Health Services Research and Development Northwest Center of Excellence, Veterans Affairs Puget Sound Health Care System, Seattle, WA, USA. OBJECTIVE: To […]

Socio-economic position and childhood multimorbidity: a study using linkage between the Avon Longitudinal study of parents and children and the general practice research database

Int J Equity Health 12:66. School of Social and Community Medicine, University of Bristol, Bristol, UK INTRODUCTION: In adults, multimorbidity is associated with social position. […]

Use of risk adjustment in setting budgets and measuring performance in primary care II: advantages, disadvantages, and practicalities

BMJ 323:607-610. School of Public Policy, University College London, London, UK Risk adjustment could help to improve decisions about budgets as well as help measure […]

Prevalence of multimorbidity according to the deprivation level among the elderly in the Basque Country

BMC Public Health 13:918. Oberri, Basque Institute for Healthcare Innovation, Sondika, Spain BACKGROUND: Multimorbidity is clearly a major challenge for healthcare systems. However, currently, its […]

Predictors of colorectal cancer screening variation among primary-care providers and clinics

Am J Gastroenterol 108:1159-1167. University of Wisconsin School of Medicine and Public Health, Madison, WI, USA OBJECTIVES: Colorectal cancer (CRC) screening is underutilized. To effect […]

Antihypertensive medication initiation among young adults with regular primary care use

J Gen Intern Med Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA BACKGROUND: Young adults with hypertension have […]

Systemwide provider performance in a Medicaid program. Profiling the care of patients with chronic illnesses

Med Care 34:798-810. Department of Health Policy and Management, Johns Hopkins University School of Public Health, Baltimore, MD, USA OBJECTIVES: This study illustrates how claims […]

Obesity and co-morbidities in type 2 diabetes: an opportunity to bend the Health Care Cost Curve

Rev Clin Esp 214:140-142. University of Southern Denmark, Odense, Denmark Obesity has long been known as a driver and predictor of the increasing global prevalence […]

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, […]

Women are less likely to be admitted for inpatient rehabilitation after hypoxic-ischemic brain injury

Arch Phys Med Rehabil 96:e17-e18. Toronto Rehabilitation Institute, Toronto, ON, Canada Objective(s): To investigate demographic and acute care clinical determinants  of admission to inpatient rehabilitation […]

Child health and young adult outcomes

J Hum Resources 45:517-548. Columbia University, New York, NY, USA; University of Toronto, Toronto, ON, Canada; University of Manitoba, Winnipeg, MB, Canada Research has shown […]

Patients gain information and skills to improve self-management through innovative tools

Quality Matters December 2010/January 2011. Commonwealth Fund, New York, NY, USA Health reform strategies such as creating patient-centered medical homes depend on an actively engaged […]

What works? A first look at evaluating Manitoba’s regional health programs and policies at the population level

Winnipeg, MB, Canada: Manitoba Centre for Health Policy. Manitoba Centre for Health Policy, University of Manitoba, Winnipeg, MB, Canada Although many descriptive healthcare studies are […]

The New Mexico primary care network

Chapter 5. 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, […]

Johns Hopkins risk tool used in south

EHI ehealth Insider :5 March 2012. More than 200 GP practices in South Central England are getting quarterly risk stratification and predictive modelling information on […]

Health system use by frail Ontario seniors: an in-depth examination of four vulnerable cohorts

Toronto, ON, Canada: Institute for Clinical Evaluative Sciences. Institute for Clinical Evaluative Sciences, Toronto, ON, Canada Key Findings OLDER WOMEN: A look at gender differences […]

Predicting elderly at risk of increased future healthcare use: how much does diagnostic information add to prior utilization?

Health Serv Outcomes Res Methodology 3:266-277. Adamian Academic Center, Bentley College, Waltham, MA, USA; Center for Health Quality, Outcomes and Economic Research, Veterans Administration Medical […]

Hopkins health pricing tool a managed care hit

Hopkins health pricing tool a managed care hit. Baltimore Business Journal July 21. Baltimore Business Journal, Baltimore, MD, USA Johns Hopkins University’s links with private […]

Event analysis of all-cause and ambulatory care sensitive hospitalization of long-stay nursing home residents

Baltimore, MD, USA: Centers for Medicare and Medicaid Services. Schneider Institutes for Health Policy, The Heller School for Social Policy and Management, Brandeis University, Waltham, […]

Adult obesity in Manitoba: prevalence, associations, and outcomes, 3rd edition

Winnipeg, MB, Canada: Manitoba Centre for Health Policy. Manitoba Centre for Health Policy, Winnipeg, MB, Canada Obesity is a major public health concern in Canada […]

Healthcare expenditure in the last year of life: the experience of South African medical schemes

Cape Town, South Africa: Actuarial Society of South Africa. School of Management Studies, University of Cape Town, Rondebosch, South Africa The aim of this paper […]

Pressupostos e proposta de modelo para a remuneração do trabalho do médico cirurgião nas operadoras de planos de saúde

São Paulo, Brazil: Fundação Getúlio Vargas, Escola de Administração de Empresas de São Paulo (doctoral dissertation). Published in Portuguese. Fundação Getúlio Vargas, Escola de Administração […]

A predictive model to identify patients at risk of unplanned 30-day acute care hospital readmission

In: 2013 IEEE International Conference on Healthcare Informatics, September 9-11, 2013, Philadelphia, PA, USA. Los Alamitos, CA, USA: IEEE:551-556. Department of Health Policy and Management, […]

Central Midlands CSU Case Study

Midlands and Lancashire CSU – ACG® System Case Management Report

Population Health and Resource Allocation Case Study Payer

Slough CCG used data output from the Johns Hopkins ACG System to gain a better understanding of their patient population, understand the factors that drive […]

Population Health Management: A Focus On Analytics Using ACGs

Johns Hopkins HealthCare LLC   Population Health Management: A Focus On Analytics Using ACGs Martha Sylvia, PhD, MBA, RN

Monday(C2)-The Association between Patient Sharing among Physicians and Cost of Care-Lemke

The Association between Patient Sharing among Physicians and Cost of Care-Klaus Lemke

Tuesday(C6)-Do Real Time Clinical Measures Improve the Performance of ACG Based Predictive Models?-Fishman

Do Real Time Clinical Measures Improve the Performance of ACG Based Predictive Models? Paul Fishman, PhD  Robert Reid, MD, PhD 

AcademyHealth 2015 HSR Impact Awardee Summary description of the ACG System

2015 HSR Impact Awardee The Johns Hopkins ACG Case-Mix System

The ACG System and Care Management

Linda Dunbar, Vice President of Population Health Care Management at Johns Hopkins HealthCare discusses how the ACG System assisted with Care Management for high-risk individuals […]

Resource Allocation Case Study-Government

The Ministry of Health in Chile used the ACG® System as a risk-adjustment mechanism to improve health care resource allocation and better describe the disease […]

High-Density Lipoprotein Cholesterol and Cause-Specific Mortality in Individuals Without Previous Cardiovascular Conditions

BACKGROUND The prognostic importance of high-density lipoprotein cholesterol (HDL-C) as a specific risk factor for cardiovascular (CV) disease has been challenged by recent clinical trials […]

Case Study: Johns Hopkins Community Health Partnership: A model for transformation

Abstract To address the challenging health care needs of the population served by an urban academic medical center, we developed the Johns Hopkins Community Health […]

Evidence on multimorbidity from definition to intervention: An overview of systematic reviews

Abstract The increasing challenge of multiple chronic diseases (multimorbidity) requires more evidence-based knowledge and effective practice. In order to better understand the existing evidence on […]

Medicaid trends in prescription opioid and non-opioid use by HIV status

Abstract   Background Pain is more common among people living with HIV (PLWH) than their counterparts; however, it is unclear whether analgesic use differs by […]

Supporting general practice to make timely decisions for better health care: a population health approach

Abstract Primary Health Networks (PHNs) are tasked to enhance the efficiency and effectiveness of general practice. Gold Coast Primary Health Network (GCPHN) has been collecting […]

Is Post-discharge Rehabilitation Timing Associated with 90-Day Readmission in Primary Total Joint Arthroplasty?

Abstract Background Physical therapy (PT) is an accepted standard of care after total joint arthroplasty (TJA) and essential to maximizing joint functionality and minimizing complications […]

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