The Association of Frailty With Outcomes and Resource Use After Emergency General Surgery: A Population-Based Cohort Study

BACKGROUND: Older patients undergoing emergency general surgery (EGS) experience high rates of postoperative morbidity and mortality. Studies focused primarily on elective surgery indicate that frailty […]

Indianapolis Provider’s Use Of Wraparound Services Associated With Reduced Hospitalizations And Emergency Department Visits

ABSTRACT Recent changes to US reimbursement policies are increasingly holding providers financially accountable for patients’ health. Providing nonmedical services in conjunction with primary care—known as […]

Healthcare costs and utilization associated with high-risk prescription opioid use: a retrospective cohort study

Abstract Background Previous studies on high-risk opioid use have only focused on patients diagnosed with an opioid disorder. This study evaluates the impact of various […]

Nonsteroidal anti-inflammatory drug use and risk of acute kidney injury and hyperkalemia in older adults: a population-based study

Abstract   Background Clinical guidelines caution against nonsteroidal anti-inflammatory drug (NSAID) use in older adults. The study objective was to quantify the 30-day risk of […]

Development of Alzheimer disease in old major depressive patients based upon their health status: A retrospective study in Taiwan

Abstract   This study is conducted to investigate the association between major depressive disorder and the subsequent development of Alzheimer disease (AD) in elderly patients […]

Symptom trajectories and predictors of severe symptoms in pancreatic adenocarcinoma at the end-of-life: a population based analysis of 2,538 patients

Abstract Background We evaluated symptom trajectories and predictors of reporting severe symptoms in the last 6 months of life among non-resected pancreatic adenocarcinoma (PAC) decedents. […]

Cardiovascular Consequences of Obstructive Sleep Apnea in Women: A Historical Cohort Study

Abstract Objective Background: Evidence on sex differences in the association between obstructive sleep apnea (OSA) and cardiovascular outcomes is limited and controversial. We conducted a […]

Is Frailty Associated With Worse Outcomes After Head and Neck Surgery? A Narrative Review

Abstract Objective Frailty has emerged as an important determinant of many health outcomes across various surgical specialties. We examined the published literature reporting on frailty […]

The Impact of Team-Based Primary Care on Guideline-Recommended Disease Screening

Abstract Introduction Family Medicine Groups, implemented in Quebec in 2002, are interprofessional primary care teams designed to improve timely access to high-quality primary care. This […]

Identification of Prenatal Opioid Exposure Within Health Administrative Databases

Abstract BACKGROUND: Health administrative data offer a vital source of data on maternal prenatal opioid exposure (POE). The impact of different methods to estimate POE, especially […]

Sepsis-Associated Mortality, Resource Use, and Healthcare Costs: A Propensity-Matched Cohort Study

Abstract Objectives: To examine long-term mortality, resource utilization, and healthcare costs in sepsis patients compared to hospitalized nonsepsis controls. Design: Propensity-matched population-based cohort study using administrative data. […]

Mental Health Services Provision in Primary Care and Emergency Department Settings: Analysis of Blended Fee-for-Service and Blended Capitation Models in Ontario, Canada

Abstract Background Treating mental illnesses in primary care is increasingly emphasized to improve access to mental health services. Although family physicians (FPs) or general practitioners […]

Associations of clinically recognized vs unrecognized vertebral fracture with mortality

Abstract Purpose Our purpose was to contrast mortality associated with clinically undiagnosed prevalent vertebral fracture recognized on densitometric vertebral fracture assessment (VFA) and prior clinically […]

Intensity of End-of-Life Care in a Cohort of Commercially Insured Women With Metastatic Breast Cancer in the United States

ABSTRACT Purpose There is limited evidence on the intensity of end-of-life (EOL) care for women < 65 years old, who account for about 40% of […]

High‐deductible health plans and low‐value imaging in the emergency department

Abstract Objective To examine the effect of an employer‐mandated switch to high‐deductible health plans (HDHP) on emergency department (ED) low‐value imaging. Data Sources Claims data […]

Primary care-based smoking cessation treatment and subsequent healthcare service utilisation: a matched cohort study of smokers using linked administrative healthcare data

ABSTRACT Background No research has assessed the individual-level impact of smoking cessation treatment delivered within a general primary care patient population on multiple forms of […]

Association between chronic bladder catheterisation and bladder cancer incidence and mortality: a population based retrospective cohort study in Ontario, Canada

Abstract Objectives To compare the risk of bladder cancer and bladder cancer mortality among patients with chronic bladder catheterisation (indwelling or intermittent) to patients from […]

Operationalizing Outpatient Palliative Care Referral Criteria in Lung Cancer Patients: A Population-Based Cohort Study Using Health Administrative Data

Abstract Background Early referral of cancer patients for palliative care significantly improves the quality of life. It is not clear which patients can benefit from […]

Association of bilateral salpingo-oophorectomy with all cause and cause specific mortality: population based cohort study

Abstract Objectives To determine if bilateral salpingo-oophorectomy, compared with ovarian conservation, is associated with all cause or cause specific death in women undergoing hysterectomy for […]

COVID-19 Hospitalizations, Intensive Care Unit Stays, Ventilation, and Death Among Patients With Immune-mediated Inflammatory Diseases Compared to Controls

Abstract Objective To investigate coronavirus disease 2019 (COVID-19) hospitalization risk in patients with immune-mediated inflammatory diseases (IMIDs) compared with matched non-IMID comparators from the general […]

The effect of disease co-occurrence measurement on multimorbidity networks: a population-based study

Abstract Background Network analysis, a technique for describing relationships, can provide insights into patterns of co-occurring chronic health conditions. The effect that co-occurrence measurement has […]

Assessing the Impact of Body Mass Index Information on the Performance of Risk Adjustment Models in Predicting Health Care Costs and Utilization.

Abstract BACKGROUND: Using electronic health records (EHRs) for population risk stratification has gained attention in recent years. Compared with insurance claims, EHRs offer novel data […]

Supporting Commissioning Activities

The first part of this webinar will provide an introduction to the ACG System, the logic used within the software to determine morbidity patterns and […]

Using the ACG System to support population health management in Baltimore city

Presented by: Melissa Sherry, MPH, CPH

Director, Population Health Innovation and Transformation, Johns Hopkins HealthCare

This webinar presents a case study of the use of the ACG System to address the needs of a high risk, low income population in Baltimore City.

Adjusted Clinical Groups as a risk assessment model for healthcare resource allocation

Rev Med Chil 142:153-160. Published in Spanish. Departamento de Desarrollo Estratégico, Ministerio de Salud. Santiago de Chile BACKGROUND: There is increasing interest in the study […]

Primary health care use from the perspective of gender and morbidity burden

BMC Womens Health 14:145. University of Zaragoza, Zaragoza, Spain; Aragon Health Sciences Institute, Zaragoza, Spain BACKGROUND: Sex and gender can interact to contribute to differences […]

Have we left some behind? Trends in socio-economic inequalities in breastfeeding initiation: a population-based epidemiological surveillance study

Can J Public Health 105:e362. Manitoba Centre for Health Policy, Winnipeg, MB, Canada OBJECTIVES: Breastfeeding is associated with improved health. Surveillance data show that breastfeeding […]

Comorbidity as a predictor of health services utilization and mortality in patients with diabetes

Gac Sanit 29:10-14. Published in Spanish. Universidad de Zaragoza, Zaragoza, España; Dirección General de Planificación y Aseguramiento, Zaragoza, España; Grupo de Investigación en Servicios Sanitarios […]

Patient sharing and quality of care: measuring outcomes of care coordination using claims data

Med Care 53:317-323. Johns Hopkins University, Baltimore, MD, USA BACKGROUND: With the goal of improving clinical efficiency and effectiveness, programs to enhance care coordination are […]

Children’s health care use in the Healthy Kids Program

Pediatrics 100:947-953. Department of Pediatrics, University of Florida, Gainsville, FL, USA BACKGROUND: In 1990, the Florida Legislature established the Florida Healthy Kids Corporation to implement […]

Effect of socioeconomic status on hepatocellular carcinoma incidence and stage at diagnosis, a population-based cohort study

Liver Int. University of Toronto, Toronto, ON, Canada; Cancer Care Ontario, Toronto, ON, Canada; University of British Columbia, Vancouver, BC, Canada; Ontario Institute for Cancer […]

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

Popul Health Manag. Intermountain Healthcare, Salt Lake City, UT, USA; University of Minnesota , Minneapolis, MN, USA; Children’s Hospitals and Clinics of Minnesota , Minneapolis, […]

Are family physicians comprehensively using electronic medical records such that the data can be used for secondary purposes?

A Canadian perspective. BMC Med Inform Decis Mak 15:67. Institute for Clinical Evaluative Sciences, Toronto, ON, Canada; University of Toronto, Toronto, ON, Canada; University Health […]

Relationship between efficiency and clinical effectiveness indicators in an adjusted model of resource consumption: a cross-sectional study

BMC Health Serv Res 13:421. Institut Universitari d’investigació en Atenció Primària Jordi Gol, Barcelona, Spain BACKGROUND: Adjusted clinical groups (ACG®) have been widely used to […]

Renewing primary care: lessons learned from the Spanish health care system

Health Aff 29:1432-1441. Department of Family Medicine at the Alpert Medical School, Brown University, in Providence, RI, USA From 1978 on, Spain rapidly expanded and […]

Risk adjustment alternatives in paying for behavioral health care under Medicaid

Health Serv Res 36:793-811. UCLA Department of Medicine, Los Angeles, CA, USA OBJECTIVE: To compare the performance of various risk adjustment models in behavioral health […]

The interaction of ethnicity and chronic disease as risk factors for osteoporotic fractures: a comparison in Canadian Aboriginals and non-Aboriginals

Osteoporos Int 17:1358-1368. Department of Medicine, University of Manitoba, Winnipeg, MB, Canada INTRODUCTION: Efforts to develop global methods for absolute fracture risk prediction are currently […]

The duration of ambulatory visits to physicians

J Fam Pract 48:264-271. Institute for Health Policy, Massachusetts General Hospital/Partners HealthCare System, Harvard Medical School, Boston, MA, USA BACKGROUND: The objective of our study […]

Factors related to frequent usage of the primary healthcare services in old age: findings from the Swedish National Study on Aging and Care

Health Soc Care Community 17:304-311. Växjö University, School of Social Sciences, Växjö, Sweden People aged 60 or more are the most frequent users of healthcare […]

Health information services technologies

J Ambul Care Manage 19:90-97. ISYS Group, Des Moines, IA, USA Increasing demands for provider profiling have led to the growth of health information services […]

Quantifying morbidities by Adjusted Clinical Group System for a Taiwan population: a nationwide analysis

BMC Health Serv Res 8:153. Department of Medical Affairs and Planning, Taipei Veterans General Hospital, Taipei City, Taiwan, ROC BACKGROUND: The Adjusted Clinical Group (ACG) […]

Case selection for a Medicaid chronic care management program

Health Care Financ Rev 30:61-74. Center for Health Policy and Research, University of Massachusetts Medical School, Shrewsbury, MA, USA Medicaid agencies are beginning to turn […]

Johns Hopkins Ambulatory Care Groups (ACGs). A case-mix system for UR, QA and capitation adjustment

HMO Pract 6:13-19. Johns Hopkins University, Baltimore, MD, USA This paper describes a new ambulatory case-mix system developed at The Johns Hopkins University and known […]

Impact of comorbidities on stroke rehabilitation outcomes: does the method matter?

Arch Phys Med Rehabil 89:1903-1906. Center for Health Quality, Outcomes and Economic Research, Bedford VA Hospital, Bedford, MA, USA OBJECTIVES: To examine the impact of […]

Pay for performance: an excellent idea that simply needs implementation

Qual Manag Health Care 14:31-44. 3M Health Information Systems, Wallingford, CT, USA Pay for performance cannot consist of a one-size-fits-all approach. Variation in quality and […]

Comparative study at 4 health centres of efficiency, measured on the basis of Ambulatory Care Groups

Aten Primaria 38:275-282. Published in Spanish. Badalona Serveis Assistencials, Badalona (Barcelona), España OBJECTIVE: To measure efficiency in the use of resources for the care lists […]

Do Adjusted Clinical Groups eliminate incentives for HMOs to avoid substance abusers? Evidence from the Maryland Medicaid HealthChoice program

J Behav Health Serv Res 30:63-77. UCLA Department of Medicine, Division of General Internal Medicine & Health Services Research, Los Angeles, CA, USA The adequacy […]

Cholecystostomy: a bridge to hospital discharge but not delayed cholecystectomy

J Trauma Acute Care Surg 74:175-179; discussion 179-80. Li Ka Shing Knowledge Institute, St Michael’s Hospital, Toronto, ON, Canada BACKGROUND: Current data on the clinical […]

Primary care safety-net delivery sites in the United States: A comparison of community health centers, hospital outpatient departments, and physicians’ offices

JAMA 284:2077-2083. Department of Health Policy and Management, Johns Hopkins School of Public Health, Baltimore, MD, USA CONTEXT: The US primary care safety net is […]

Psychiatric illness and subsequent traumatic brain injury: a case control study

J Neurol Neurosurg Psychiatry 72:615-620. Department of Psychiatry, University of Washington, Seattle, WA, USA OBJECTIVE: To determine whether psychiatric illness is a risk factor for […]

Population-based medical and disease management: an evaluation of cost and quality

Dis Manag 9:45-55. UMHS Medical Management Center, University of Michigan, Ann Arbor, MI, USA Reports by the Institute of Medicine and the Health Care Financing […]

Regression tree boosting to adjust health care cost predictions for diagnostic mix

Health Serv Res 43:755-772. Healthcare Management and Statistical Consulting, 4303 Stanford Street, Chevy Chase, MD, USA OBJECTIVE: To assess the ability of regression tree boosting […]

The contribution of longitudinal comorbidity measurements to survival analysis

Med Care 47:813-821. Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA, USA BACKGROUND: Many clinical and health services research studies are […]

Income inequities in end-of-life health care spending in British Columbia, Canada: A cross-sectional analysis, 2004-2006

Int J Equity Health 10:12. Centre for Health Services and Policy Research, University of British Columbia, Vancouver BC, Canada BACKGROUND: This study aimed to measure […]

Selection bias explains apparent differential mortality between dialysis modalities

Selection bias explains apparent differential mortality between dialysis modalities. J Am Soc Nephrol 22:1534-1542. University of Calgary, Calgary, AB, Canada The relative risk of death […]

Measuring data reliability for preventive services in electronic medical records

BMC Health Serv Res 12:116. Department of Family and Community Medicine, University of Toronto, Toronto, ON, Canada BACKGROUND: Improvements in the quality of health care […]

Influence of chronic co-morbidity on health costs

Med Clin (Barc) 138:179-180. Published in Spanish. Dirección de Planificación, Badalona Serveis Assistencials, Barcelona, Spain Launched in 1943, Medicina Clínica is a fortnightly journal aimed […]

Comparing measures of multimorbidity to predict outcomes in primary care: a cross sectional study

Fam Pract 30:172-178. Academic Unit of Primary Care, School of Social and Community Medicine, University of Bristol, Bristol, UK BACKGROUND: An increasing proportion of people […]

Productivity and patient satisfaction in primary care — conflicting or compatible goals?

Health Policy 111:157-165. Lund University School of Economics and Management, Lund, Sweden Following recent reforms in Swedish primary care, providers are accountable to both citizens […]

Metformin use and all-cause and prostate cancer-specific mortality among men with diabetes

J Clin Oncol 31:3069-3075. Princess Margaret Hospital, University Health, Toronto, ON, Canada PURPOSE: To evaluate the association between cumulative duration of metformin use after prostate […]

Hospitalizations and emergency department use in Mayo Clinic Biobank participants within the employee and community health medical home

Mayo Clin Proc 88:963-969. Division of Primary Care Internal Medicine, Department of Medicine, Mayo Clinic, Rochester, MN, USA OBJECTIVE: To evaluate the participants in the […]

A model based on age, sex, and morbidity to explain variation in UK general practice prescribing: cohort study

BMJ 337:a238. Department of Statistical Science, University College London, London, UK OBJECTIVE: To examine whether patient level morbidity based measure of clinical case mix explains […]

Can gender difference in prescription drug use be explained by gender-related morbidity? A study on a Swedish population during 2006

BMC Public Health 14:329. Department of Clinical Sciences in Malmö, Center for Primary Health Care Research, Lund University, Malmö, Sweden BACKGROUND: It has been reported […]

Long-term care benefits may reduce end-of-life medical care costs

Popul Health Manag Univita , Natick, MA, USA This study explores whether personal care services for functionally dependent or cognitively impaired individuals paid for by […]

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 […]

Improve Patient Coordination Through Care Management

Coordinating care and sharing clinical information across the continuum of care has been shown to improve health care outcomes and health care delivery efficiencies. The […]

The Discovery Health experience with the ACG System in South Africa

Discovery Health The Discovery Health experience with the ACG System in South Africa Dr. Dianne Walker

Association between Continuity of Care and Avoidable Hospitalization in Taiwan

Veteran General Hospital – Taipei Continuity of Care and Its Association to Avoidable Hospitalizations of Taiwan’s Veterans: A Preliminary Study Ping Tao, RN., MHA


Johns Hopkins ACG System Future Directions and Opportunities in the Predictive Modeling and Risk Adjustment Fields: The Next 20 Years of the ACG System Jonathon […]

Tuesday-Management implications-Reams

Brown & Toland Physicians Using Risk Adjustment to Measure Access to Primary Care Kam Reams, MPhil, MPH Manager, Performance Improvement

Monday-Leveraging pharmacy data-Bodycombe

Johns Hopkins ACG System Expanded Horizons for Pharmacy Gap Analysis David Bodycombe

The development path for the ACG System

ACG System Johns Hopkins Bloomberg School of Public Health ACG v11 Introduction to New Tools for Understanding and Managing Population Health Stephen Sutch

Tuesday(C7)-Use of Adjusted Clinical Groups (ACGs) in implementing Chronic Disease Management Programs: preliminary experiences in north- eastern Italy

Use of Adjusted Clinical Groups (ACGs) in implementing Chronic Disease Management Programs: preliminary experiences in north- eastern Italy —Pietro Gallina, Carlo Rampazzo, Stefania Elvini, Domenico […]

Monday(C2)-Quality of Care in Multimorbid Patients-Shadmi

Quality of Care in Multimorbid Patients Efrat Shadmi, PhD, Ran D. Balicer, MD, MPH, PhD

Use of Johns Hopkins ACG System in the UK to Support Case Finding Similarities to the US Health Care System

What are the challenges facing health care in the UK? Are these similar or different to the challenges faced by the health care organizations in […]

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 […]

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