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Documents

Adverse events recorded in English primary care: observational study using the General Practice Research Database

Br J Gen Pract 63:534-542. Department of Primary Care and Public Health (DPCPH), Imperial College London, London, UK BACKGROUND: More accurate and recent estimates of […]

The roles of primary care PAs and NPs caring for older adults with diabetes

JAAPA 27:45-49. Duke University School of Medicine, Durham, NC; Veterans Affairs Pittsburgh Healthcare System and University of Pittsburgh School of Pharmacy, Pittsburgh, PA; University of […]

Profiling resource use by primary-care practices: managed Medicare implications

Health Care Financ Rev 17:23-42. Project HOPE Center for Health Affairs, Bethesda, MD, USA Variations in elderly Medicare beneficiaries’ health service use are examined using […]

Evaluating case-mix and predictive modeling measures within the British primary care sector

BMC Health Serv Res 7:A8. Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA; Imperial College London, UK Aim: The goal of this project […]

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 […]

Population-based Study of the Effect of Free Influenza Vaccination on Medical Utilization of Elderly

National Yang Ming University A Population-based Study of the Effect of Free Influenza Vaccination on Medical Utilization of Elderly Taiwanese Ching Wen Chien, Ph.D.

Population risk stratification to support strategic planning and commissioning

NHS Midlands and Lancashire Commissioning Support Unit Population Level Risk Stratification to Support Strategic Planning and Commissioning  

Wednesday(C9)-The Creation of New Models to Predict Future Resource Use and Risk of Hospital Admission for a General Population in NHS England —Stephen Sutch

The Creation of New Models to Predict Future Resource Use and Risk of Hospital Admission for a General Population in NHS England —Stephen Sutch, Johns […]

Tuesday(C7)-Development of the case finding tool using the ACG system-Roberts

Development of the case finding tool using the ACG system Kevin Roberts

Readmissions: What Health Plans Need to Know

Preventing avoidable hospital readmissions is considered by many to be the most important opportunity for reducing waste in health care. This podcast explains readmissions and why identifying these at-risk patients is important to health plans. Learn more.

Case Mix Adjustment Case Study – Payer

This Case Study shows how Leicester City CCG, one of the most ethnically diverse areas of the UK, analyzed emergency admission rates for all practices, to learn that practices with lower emergency admission rates had significantly higher coding completeness and GP patient survey scores. Learn more.

Post-acute pathways among hip fracture patients: a system-level analysis

Background: Hip fractures among older adults are one of the leading causes of hospitalization and result in significant morbidity, mortality, and health care use. Guidelines […]

Examination of Health System Resources and Costs Associated With Transitioning Cancer Survivors to Primary Care: A Propensity-Score–Matched Cohort Study

Background: Transitioning low-risk cancer survivors back to their primary care provider (PCP) has been shown to be safe but the effect on health system resources […]

Using EMRALD to assess baseline body mass index among children living within and outside communities participating in the Ontario, Canada Healthy Kids Community Challenge

Abstract   Objectives The Healthy Kids Community Challenge is a large-scale, centrally-coordinated, community-based intervention in Ontario, Canada that promotes healthy behaviours towards improving healthy weights […]

The Association Between Continuity of Primary Care and Preventive Cancer Screening in Women With Intellectual Disability

Abstract Women with intellectual disability have low screening rates for breast and cervical cancer. This population-based cohort study examined the association between the level of […]

The Lifestyle Medicine Physician’s Case to Self-Insured Employers: A Business Model for Physicians, a Bargain for Companies

Abstract   A majority of Americans have health care insurance through their employers, the cost for which is rising at an alarming rate. Unfortunately, higher […]

Predicting Short-Term Outcomes After Radical Cystectomy Based on Frailty

Abstract Objective To evaluate the impact of frailty on adverse perioperative outcomes in patients treated with radical cystectomy for bladder cancer. Material and Methods We […]

Production of physician services under fee‐for‐service and blended fee‐for‐service: Evidence from Ontario, Canada

Abstract We examine family physicians’ responses to financial incentives for medical services in Ontario, Canada. We use administrative data covering 2003–2008, a period during which […]

Patient frailty predicts worse perioperative outcomes and higher cost after radical cystectomy

Abstract Background Relatively few studies investigated the importance of frailty in radical cystectomy (RC) patients. We tested the ability of frailty, using the Johns Hopkins […]

Patient-reported symptoms following diagnosis in esophagus cancer patients treated with palliative intent

Summary The majority of patients with esophagus cancer have advanced-stage disease without curative options. For these patients, treatment is focused on improving symptoms and quality […]

Peri‐complication diagnosis of hepatitis C infection: Risk factors and trends over time

Abstract Background & Aims Hepatitis C virus (HCV) is a common and treatable cause of cirrhosis and its complications, yet many chronically infected individuals remain […]

Using Health Plan Authorization Data to Predict Hospitalizations and Readmissions in a Combined Commercial and Medicaid Population

Abstract Health plans develop predictive models to predict key clinical events (eg, admissions, readmissions, emergency department visits). The authors developed predictive models of admissions and […]

Association between socioeconomic deprivation and surgical complications in adults undergoing ankle fracture fixation: a population-based analysis

Abstract Background Few studies have investigated the outcomes of surgical fracture care among socially deprived patients despite the increased incidence of fractures and the inequality […]

Breast cancer diagnosis and treatment wait times in specialized diagnostic units compared with usual care: a population-based study

Abstract Background Breast assessment sites (bass) were developed to provide expedited and coordinated care for patients being evaluated for breast cancer (bca) in Ontario. We […]

Epidemiology and Impact of Spinal Cord Injury in the Elderly: Results of a Fifteen-Year Population-Based Cohort Study

Abstract Objective Although experience suggests a shift in the epidemiology of spinal cord injury (SCI) toward an older demographic, population studies are lacking. We aimed […]

Systematic review on the instruments used for measuring the association of the level of multimorbidity and clinically important outcomes

ABSTRACT Objectives There are multiple instruments for measuring multimorbidity. The main objective of this systematic review was to provide a list of instruments that are […]

Inequities in access to primary care among opioid recipients in Ontario, Canada: A population-based cohort study

Abstract Background Stigma and high-care needs can present barriers to the provision of high-quality primary care for people with opioid use disorder (OUD) and those […]

Prevalence, determinants, and outcomes of SARS-COV-2 infection among cancer patients. A population-based study in northern Italy

Abstract Background It is well established that cancer patients infected with SARSCoV-2 are at particularly elevated risk of adverse outcomes, but the comparison of SARS-CoV-2 […]

Outcomes after the regionalization of care for high-grade endometrial cancers: a population-based study

Abstract Background In June 2013, Ontario Health (Cancer Care Ontario), the agency responsible for advancing cancer care in Ontario, Canada, published practice guidelines recommending that […]

Pre-operative wait times in high-grade non-endometrioid endometrial cancer: Do surgical delays impact patient survival?

Abstract Objective Practice guidelines advocating for regionalization of endometrial cancer surgery to gynecologic oncologists practicing in designated gynecologic oncology centres were published in Ontario in […]

Patterns Of Multimorbidity Of Patients In Geriatric Care – A Register-Based Cohort Study In Sweden

Abstract Background Patients in geriatric care display a high degree of multimorbidity. We aimed to explore and visualise various patterns of multimorbidity in a person-oriented […]

Impact of Social Needs in Electronic Health Records and Claims on Health Care Utilization and Costs Risk-Adjustment Models Within Medicaid Population

Abstract Patients enrolled in Medicaid have significantly higher social needs (SNs) than others. Using claims and electronic health records (EHRs) data, managed care organizations (MCOs) […]

Association of a Care Coordination Model With Health Care Costs and Utilization The Johns Hopkins Community Health Partnership (J-CHiP)

Abstract Importance  The Johns Hopkins Community Health Partnership was created to improve care coordination across the continuum in East Baltimore, Maryland. Objective  To determine whether the Johns […]

Case Management and Care Coordination Part 1

This webinar will provide an overview of the data available within the ACG System to support case finding activities. The topics covered will include the […]

Case Mix Adjustment in Primary Care

Presented by: Dr. David Shepherd FRCGP

This webinar shares a case study of Leicester CCG in the UK. The ACG System was used to analyze emergency admission rates for all practices in the area. The top 8 practices were identified and studied further to understand key characteristics of those practices.

Developing a dashboard to help measure and achieve the triple aim: a population-based cohort study

BMC Health Serv Res 14:363. McMaster University, Hamilton, ON, Canada BACKGROUND: Health system planners aim to pursue the three goals of Triple Aim: 1) reduce […]

Performance of the ACG case-mix system in two Canadian provinces.

Med Care 39:86-99. Centre for Health Services and Policy Research, University of British Columbia, Vancouver, BC, Canada BACKGROUND: While the adjusted clinical group (ACG) system […]

Identifying possible indicators of systematic overuse of health care procedures with claims data

Med Care 52:157-163. Department of Health Policy and Management, Johns Hopkins University, Baltimore, MD, USA BACKGROUND: Health care quality is frequently described with measures representing […]

Evaluating diagnosis-based case-mix measures: how well do they apply to the VA population?

Med Care 39:692-704. Center for Health Quality, Outcomes and Economic Research, Bedford VAMC, MA, USA BACKGROUND: Diagnosis-based case-mix measures are increasingly used for provider profiling, […]

The association between continuity of care and the overuse of medical procedures

JAMA Intern Med Johns Hopkins University, Baltimore, MD, USA Importance: Both the overuse of unnecessary medical procedures and poor continuity of care are thought to […]

Effect of attribution length on the use and cost of health care for a pediatric Medicaid Accountable Care Organization

JAMA Pediatr 170:148-154. Children’s Hospitals and Clinics of Minnesota, Minneapolis, MN, USA IMPORTANCE: Little is known about the effect of pediatric accountable care organizations (ACOs) […]

Factors associated with acute care use among nursing home residents dying of cancer: a population-based study

Int J Palliat Nurs 21:349-356. McMaster University, Hamilton, ON, Canada BACKGROUND: Little is known about residents of long-term care (LTC) facilities who die of cancer. […]

Predictors of opioid-related death during methadone therapy

J Subst Abuse Treat 57:30-35. University of Toronto, ON, Canada; Institute for Clinical Evaluative Sciences, Toronto, ON, Canada; St. Michael’s Hospital, Toronto, ON, Canada; St. […]

The potential for community-based health information exchange systems to reduce hospital readmissions

J Am Med Inform Assoc 22:435-442. Weill Cornell Medical College, New York, NY, USA BACKGROUND: Hospital readmissions are common, costly, and offer opportunities for utilization […]

Fifty years of pediatric asthma in developed countries: how reliable are the basic data sources?

Pediatr Pulmonol 47:211-219. British Columbia’s Children’s Hospital, Vancouver, BC, Canada Given the difficulties in diagnosing, or even defining, asthma in children, claims of a pediatric […]

Application of the Ambulatory Care Groups in the primary care of a European national health care system: does it work?

Med Care 37:238-248. Astrabudúa Health Center, Osakidetza/Basque Health Service, Bizkaia, Spain BACKGROUND: Ambulatory Care Groups (ACGs), a US case mix system that uses the patient […]

Quality assessment: is the focus on providers or on patients?

Int J Qual Health Care 8:231-241. Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, USA Most studies of ambulatory care quality are based on chart […]

Biphasic fracture risk in diabetes: a population-based study

Bone 40:1595-1601. Department of Medicine, University of Manitoba, Winnipeg, MB, Canada Diabetes is associated with increased fracture rates but the effect size, time course and […]

The comorbidity burden of the treated asthma patient population in British Columbia

Chronic Dis Can 30:46-55. University of British Columbia, Faculty of Pharmaceutical Sciences, Vancouver, BC, Canada To date there has been little investigation of the prevalence […]

Nonparticipation in a population-based trial to increase colorectal cancer screening

Am J Prev Med 42:390-397. Group Health Permanente, University of Washington Medical School, Seattle, WA, USA BACKGROUND: Many trials have tested different strategies to increase […]

Institutionalization following incident non-traumatic fractures in community-dwelling men and women

Osteoporos Int 23:2381-2386. Division of General Internal Medicine, McGill University Health Center, Montreal, QC, Canada Institutionalization after hip fracture occurs in at least 30% of […]

Methods for analyzing health care utilization and costs

Annu Rev Public Health 20:125-144. Department of Biostatistics, University of Washington, Seattle, WA, USA Important questions about health care are often addressed by studying health […]

Mortality rates after incident non-traumatic fractures in older men and women.

Osteoporos Int 22:2439-2448. Division of General Internal Medicine, McGill University Health Center, Montreal, QC, Canada Non-traumatic fractures at typical osteoporotic sites are associated with increased […]

Comorbidity patterns in patients with chronic diseases in general practice

PLoS One 7:e32141. Multiprofessional Education Unit for Family and Community Care (Southwest), Madrid, Spain INTRODUCTION: Healthcare management is oriented toward single diseases, yet multimorbidity is […]

Primary care physician compensation method in medical groups: does it influence the use and cost of health services for enrollees in managed care organizations?

JAMA 279:853-858. Department of Health Services, University of Washington, Seattle, WA, USA CONTEXT: Growth of at-risk managed care contracts between health plans and medical groups […]

Health-based payment and computerized patient record systems

Eff Clin Pract 1:66-72. Center for Health Research, Kaiser Permanente, Northwest Division, Portland, OR, USA. Health care information technology is changing rapidly and dramatically. A […]

Morbidity and older persons’ perceptions of the quality of their primary care

J Am Geriatr Soc 54:330-334. Department of Health Policy and Management, Bloomberg School of Public Health, School of Medicine, Johns Hopkins University, Baltimore, MD, USA […]

Primary care physicians’ experiences with case finding for practice-based care management

Am J Manag Care 18:e155-161. Department of General Practice and Health Services Research, University Hospital Heidelberg, Heidelberg, Germany. OBJECTIVES: The identification of patients most likely […]

A population-based analysis of the clinical course of 10,304 patients with acute cholecystitis, discharged without cholecystectomy

J Trauma Acute Care Surg 74:26-30; discussion 30-1. Li Ka Shing Knowledge Institute, St Michael’s Hospital; and Institute for Clinical Evaluative Science, Toronto, ON, Canada […]

Self-referral in point-of-service health plans

JAMA 285:2223-2231. Department of Health Policy and Management, Johns Hopkins School of Hygiene and Public Health, Baltimore, MD, USA CONTEXT: Most health maintenance organizations offer […]

Cost and quality trends in direct contracting arrangements

Health Aff 21:89-102. Health Systems Management Faculty, School of Public Affairs, University of Baltimore, Baltimore, MD, USA. This paper presents the first empirical analysis of […]

Impact of open-access scheduling on realized access

Health Serv Manage Res 20:134-139. Department of Family Medicine, Mayo Clinic, Rochester, MN, USA Open-access or advanced-access scheduling, which opens the clinic calendar to patients […]

Influence of morbidity and the use of health resources in patients who require care for generalised anxiety disorder in the primary health care setting

Aten Primaria 40:603-610. Published in Spanish. Dirección de Planificación. Badalona Serveis Assistencials, S.A. Badalona. Barcelona, Spain OBJECTIVE: To evaluate the co-morbidity, health care use, economical […]

Patterns in the use of benzodiazepines in British Columbia: examining the impact of increasing research and guideline cautions against long-term use

Health Policy 97:122-129. Centre for Health Services and Policy Research, University of British Columbia, Vancouver, BC, Canada OBJECTIVE: We examined changes in patterns of benzodiazepine […]

Who cares for Medicaid-enrolled children with chronic conditions?

Pediatrics 108:906-912. Center for Child and Adolescent Health Policy, MassGeneral Hospital for Children, Boston, MA, USA OBJECTIVE: To estimate generalist, pediatric subspecialist, and any subspecialist […]

Predicting the risk of 1-year mortality in incident dialysis patients: accounting for case-mix severity in studies using administrative data

Med Care 49:257-266. Faculty of Medicine, University of Calgary, Calgary, AB, Canada BACKGROUND: Administrative databases are increasingly being used to study the incident dialysis population […]

Tracking family medicine graduates. Where do they go, what services do they provide and whom do they see?

BMC Fam Pract 13:26. Department of Family and Community Medicine, University of Toronto, Toronto, ON, Canada BACKGROUND: There are continued concerns over an adequate supply […]

Cost analysis of adding pregabalin or gabapentin to the management of community-treated patients with peripheral neuropathic pain

J Eval Clin Pract 18:1170-1179. Badalona Serveis Assistencials, Badalona, Barcelona, Spain OBJECTIVE: To compare the cost of adding either pregabalin or gabapentin to the management […]

A new simple primary care morbidity score predicted mortality and better explains between practice variations than the Charlson index

J Clin Epidemiol 66:436-444. Population Health Research Centre, Division of Population Health Sciences and Education, St George’s University of London, London, UK OBJECTIVES: Adjustment for […]

Doctor shopping by overweight and obese patients is associated with increased healthcare utilization

Obesity 21:1328-1334. Division of General Internal Medicine, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA. OBJECTIVE: Negative interactions with healthcare providers […]

Patient poverty and workload in primary care: study of prescription drug benefit recipients in community health centres

Can Fam Physician 59:384-390. Lamont Primary Health Care Research Centre, Bruyère Research Institute, Ottawa, ON, Canada Erratum in: Can Fam Physician. 2013 Jun;59(6):612. OBJECTIVE: To […]

Movement disorders in elderly users of risperidone and first generation antipsychotic agents: a Canadian population-based study

PLoS One 8:e64217. Faculty of Pharmacy, University of Manitoba, Winnipeg, MB, Canada BACKGROUND: Despite concerns over the potential for severe adverse events, antipsychotic medications remain […]

Patient and Physician Factors Associated With Pulmonary Function Testing for COPD: A Population Study

Chest 145:272-281. Institute for Clinical Evaluative Sciences; Sunnybrook Research Institute; Sunnybrook Health Sciences Centre; University of Toronto, Toronto, ON, Canada BACKGROUND: The diagnosis of COPD […]

Identifying controlled substance patterns of utilization requiring evaluation using administrative claims data

Am J Manag Care 10:783-790. HSI Network LLC, USA OBJECTIVES: To develop a systems approach to identify, for further evaluation, patients with potential controlled substance […]

The meaningful use of electronic health records and health care quality

Am J Med Qual 30:512-519. Weill Cornell Medical College, New York, NY, USA The federal government is investing approximately $30 billion in incentives for adoption […]

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 […]

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