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Creating meaningful composite scores for primary care

2015 North American Primary Care Research Group Annual Meeting, October 2015, Cancun, Mexico. Context: Composite scores (CSs) provide a global measure of quality. CS development […]

Long-term risk of heart failure associated with adjuvant trastuzumab in breast cancer patients

2014 American Society of Clinical Oncology Annual Meeting. Abstract 9504. J Clin Oncol 32 (suppl; abstr 9504). University of Toronto, Toronto, ON, Canada; St. Michael’s […]

Is the class half empty? A population-based perspective on socioeconomic status and educational outcomes

IRPP Choices 12:1-30. Manitoba Centre for Health Policy, Department of Community Health Sciences, Faculty of Medicine University of Manitoba, Winnipeg, MB, Canada The purpose of […]

Characteristics of risk adjustment systems. Working Paper Series 2

Gainesville, FL, USA: Institute for Child Health Policy, University of Florida. Institute for Child Health Policy, University of Florida, Gainesville, FL, USA Increasing numbers of […]

Using the ACG case-mix adjustment system to evaluate veteran’s morbidity burdens and medical utilizations in Taiwan

J Healthc Manag 8:67-84. Published in Chinese. Department of Medical Affairs and Planning, Taipei Veterans General Hospital, Taipei City, Taiwan, ROC OBJECTIVES: Veterans have been […]

Performance of risk adjusted capitated systems in allocating a global budget

Baltimore, MD, USA: Johns Hopkins University (doctoral dissertation). Johns Hopkins University, Baltimore, MD, USA Rapidly rising health care costs in the United States have led […]

The Adjusted Clinical Groups (ACGs) system in Osakidetza

Final report (1/05/2003 – 30/04/2003). Vitoria-Gasteiz, Spain: Osakidetza Servicio vasco de salud. Published in Spanish. Osakidetza Servicio vasco de salud, Vitoria-Gasteiz, Spain No abstract

How are Manitoba’s children doing?

Winnipeg, MB, Canada: Manitoba Centre for Health Policy. Manitoba Centre for Health Policy, Winnipeg, MB, Canada The health and development of Manitoba’s children were examined […]

Using selected diagnoses to improve the Chilean capitation formula

Greifswald, Germany: Ernst Moritz Arndt University of Greifswald. Ernst Moritz Arndt University of Greifswald, Greifswald, Germany OBJECTIVES: To contribute to the policy discussion of equity […]

Home health services in British Columbia: a portrait of users and trends over time

Home health services in British Columbia: a portrait of users and trends over time. Vancouver, BC, Canada: University of British Columbia. University of British Columbia, […]

The effect of a coordinated care program on uninsured, chronically ill patients

Richmond, VA, USA: Virginia Commonwealth University (doctoral dissertation). Virginia Commonwealth University, Richmond, VA, USA This study explored how being enrolled in a program that both […]

Equity in the use and financing of medicines in British Columbia before and after the move to income-based pharmacare

Vancouver, BC, Canada: University of British Columbia (doctoral dissertation). University of British Columbia, Vancouver, BC, Canada BACKGROUND: In May 2003, the B.C. government introduced an […]

Utilizacion de servicios de salud en atencion primaria del area 11 de Madrid y nivel psicobioquimico de estres y de salud bucodental en su poblacion immigrante y autoctona

Madrid, Spain: Universidad Complutense de Madrid (masters thesis). Published in Spanish. Universidad Computense de Madrid, Madrid, Spain La naturaleza trashumante de la Humanidad le es […]

Developing decision trees to classify patients suited for similar interventions by combining clinical judgments with Leeds Risk Stratification Tool

London, UK: London School of Economics and Political Science. London School of Economics and Political Science, London, UK The objectives of the project are to […]

What is most important: social factors, health selection, and adolescent educational achievement

Soc Indic Res 110:385-414. Department of Community Health Sciences, Faculty of Medicine, Manitoba Centre for Health Policy, University of Manitoba, Winnipeg, MB, Canada This paper […]

Case Finding & Population Profiling – Separate Disciplines or Both Sides of the Same Coin?

This award-winning document presented at the 2015 PCSI conference highlights work undertaken with Slough Clinical Commissioning Group in the UK. The work has challenged some […]

Leicester City CCG Case Study 2

 Use of ACG® System output to support practices in participating in a medicines management scheme – STOPP-START

Care Management Program Case Study-Payer

Clalit Health (an integrated delivery system in Israel) used the ACG System to identify high-risk patients for enrollment in a comprehensive complex care management program […]

Case-Mix Information Uses and Health Services Sustainability

Iasist Casemix Information Uses and Health Services Sustainability: A Few Examples From Current Spanish Downturn Mercè Casas Carles Illa

Options for Concurrent Risk Assessment

DST Health Solutions Options for Concurrent Risk Assessment Amy Salls

Monday(C2)-Steep Increase of Registered Diagnosis Due to New Primary Care Funding Model-Martin Fredriksson

Steep Increase of Registered Diagnosis Due to New Primary Care Funding Model —Martin Fredriksson Region Västra Götaland Medical Advisor at Healtcare Department M.D. Ph.D.

Wednesday(P4)-Population Health Emerging Risk-Medscheme

Population Health Emerging Risk-Medscheme

PREDICTING HEALTHCARE COSTS IN VENETO REGION WITH ACG SYSTEM: VALIDATION AND COMPARISON OF DIAGNOSIS-BASED AND DRUG-BASED MORBIDITY GROUPS IN A NORTHERN ITALIAN POPULATION 

F. Avossa, 1, M.C. Corti, 2 , E. Schievano1, C. Abrams, 3 , N. Alba,  4 , S. Elvini, 5 , P. Gallina,  5, C. […]

Cost Risk Scores: Amy Salls, DST Health Solutions

ACG System The Johns Hopkins ACG® System Cost Risk Models Amy Salls

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The ACG System and Public Health

Joshua Sharfstein, MD, Associate Dean of the Office of Public Health Practice & Training, Johns Hopkins Bloomberg School of Public Health and former Secretary of […]

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Provider Profiling and Engagement Case Study – Payer

Johns Hopkins HealthCare (JHHC), the managed care arm of Johns Hopkins, created Provider Profile reports leveraging outputs from the Johns Hopkins ACG System to build a comprehensive Provider Engagement program.

Relation between primary care physician supply and diabetes care and outcomes: a cross-sectional study

Background: Higher primary care physician supply is associated with lower mortality due to heart disease, cancer and stroke, but its relation to diabetes care and […]

Home Palliative Service Utilization and Care Trajectory Among Ontario Residents Dying on Chronic Dialysis

Background: Many patients who receive chronic hemodialysis have a limited life expectancy comparable to that of patients with metastatic cancer. However, patterns of home palliative […]

Association Between Wait Time for Transcatheter Aortic Valve Replacement and Early Postprocedural Outcomes

Abstract Background Rapid growth in transcatheter aortic valve replacement (TAVR) demand has translated to inadequate access, reflected by prolonged wait times. Increasing wait times are […]

Variation in Revascularization Practice and Outcomes in Asymptomatic Stable Ischemic Heart Disease

Abstract   Objectives The aims of this study were to assess variation in revascularization of asymptomatic patients with stable ischemic heart disease, identify the predictors of variation, and […]

Trends in Providing Out-of-Office, Urgent After-Hours, and On-Call Care in British Columbia

Abstract   PURPOSE Providing care in alternative (non-office) locations and outside office hours are important elements of access and comprehensiveness of primary care. We examined […]

Impact of Predialysis Psychosocial Conditions on Kidney Transplant Recipient Survival: Evidence Using Propensity Score Matching

Abstract Background: An increased number of end-stage renal disease patients suffer psychosocial conditions and may experience delayed access to transplantation due to listing restrictions. However, […]

Days spent at home in the last 6 months of life: a quality indicator of end of life care in patients with hematologic malignancies

Abstract Despite advances in the management of hematologic malignancies, a significant proportion of patients die of their disease. We used administrative databases in Ontario, Canada […]

Comparison of Cardiovascular Risk Factors and Outcomes Among Practicing Physicians vs the General Population in Ontario, Canada

Abstract IMPORTANCE Although cardiovascular disease is the leading cause of death in most developed countries, little is known about current physicians’ cardiovascular health and outcomes. […]

Overall mortality and causes of death in newly admitted nursing home residents

Abstract Background In spite of a rapidly ageing population, there is a lack of population-based data on mortality among nursing home residents in Southern Europe. […]

The measurement of multimorbidity.

Abstract Overview: The presence of multiple concurrent medical conditions (also known as multimorbidity) is now a common phenomenon, hence the importance of its measurement. Objective: […]

Medication use and its impact on high-cost health care users among older adults: protocol for the population-based matched cohort HiCOSTT study

Abstract Background Health interventions and policies for high-cost health care users (HCUs) who are older adults need to be informed by a better understanding of […]

Overall Health Care Cost During the Year Following Diagnosis of Colorectal Cancer Stratified by History of Colorectal Evaluative Procedures

Abstract Background The cost-effectiveness of colorectal screening has been modeled; however, the cost of health care following the diagnosis of colorectal cancer has not been […]

Association Between Switching to a High-Deductible Health Plan and Major Cardiovascular Outcomes

Abstract Objective To describe the association between enrollment in high-deductible health plans and the risk of major adverse cardiovascular outcomes. Design, Setting, and Participants This […]

Emergency department use in people who experience imprisonment in Ontario, Canada

Abstract Objectives The aims of this study were to describe emergency department (ED) utilization by people in provincial prison and on release, and to compare […]

Healthcare services use and costs for a cohort of high needs elderly diabetic patients

Abstract Background The worldwide prevalence of diabetes mellitus is increasing, which especially involves people aged >65 years. A recent study also found that almost 75% […]

Individual and social determinants of SARS-CoV-2 testing and positivity in Ontario, Canada: a population-wide study

ABSTRACT Background Optimizing the public health response to reduce the burden of COVID-19 necessitates characterizing population-level heterogeneity of risks for the disease. However, heterogeneity in […]

The influence of frailty on postoperative complications in geriatric patients receiving single-level lumbar fusion surgery

Abstract Purpose This study evaluates the influence of patient frailty status on postoperative complications in those receiving single-level lumbar fusion surgery. Methods The nationwide readmission […]

Medical use of cocaine and perioperative morbidity following sinonasal surgery—A population study

Abstract Background Topical cocaine is favoured by many surgeons for sinonasal surgery due to its superior vasoconstrictive and anesthetic properties. However, historical reports suggesting cocaine […]

Risk Factors and Outcomes of Early Hospital Readmission in Canadian Kidney Transplant Recipients: A PopulationBased Multi-Center Cohort Study

Abstract Background Early hospital readmissions (EHRs) occur commonly in kidney transplant recipients. Conflicting evidence exists regarding risk factors and outcomes of EHRs. Objective To determine […]

Understanding Deductible and Reimbursement Maximum:A Study of Rural China’s Tiered Medical System

Abstract A high-deductible coverage is shown to reduce inappropriate health care, while little is known about its effect on social welfare under a reimbursement limit. […]

Claims-based pharmacy markers for comprehensive medication management program case identification: Validation against concurrent and prospective healthcare costs and utilization

Abstract Background Three claims-based pharmacy markers (complex, costly and risky medications) were developed to help automatically identify patients for comprehensive medication management. Objective To evaluate […]

Estimating The Marginal Productivity Of Health Technology Adoption

Abstract Decisions to adopt health technologies rely, in part, on judgements about cost effectiveness. Cost effectiveness is commonly assessed against a willingness-to-pay threshold for health […]

Care Coordination Engagement Patterns in Long-Term Patients

Abstract OBJECTIVE: Health care networks are increasingly turning to programs that provide office-based care coordination to high-cost, high-need patients to control preventable health care costs. […]

More Employers Offer Preventive Drug Lists Over Time

ABSTRACT Objective: To describe trends in employer preventive drug list (PDL) offerings and associations of employer PDL offerings with employer and workforce characteristics. Study Design: […]

Percutaneous Endoscopic Gastrostomy (PEG) Tube Placement in Frail Patients: Exploring Postprocedural Outcomes and Readmissions Using the National Readmission Database, 2018–2020

Abstract Objective Percutaneous endoscopic gastrostomy (PEG) tube placement is a common gastrointestinal procedure that provides nutrition, fluids, and medications to patients with inadequate oral intake. […]

Frailty and body composition as predictors of postoperative outcomes in patients with epithelial ovarian cancer undergoing neoadjuvant chemotherapy

Abstract Objective To assess whether the five-factor modified frailty index (mFI5) can predict adverse post-operative outcomes in patients with epithelial ovarian cancer (EOC) undergoing interval […]

Predicting Return Home After Moderate-to-Severe Traumatic Brain Injury

Abstract Background and Objectives Days alive and at home (DAH) is a validated outcome measure that captures health care transitions between time spent at home […]

Review of Risk Factors for Opioid Misuse and Addiction Following Traumatic Injury

Abstract Traumatic injuries represent a significant public health challenge, affecting millions worldwide annually and necessitating acute pain management that frequently involves the use of opioid […]

Factors affecting lung cancer stage at diagnosis and receipt of surgery in Ontario: A population-based analysis

Abstract Lung cancer is the leading cause of cancer mortality in Canada, with most cases diagnosed at advanced stage. Despite universal healthcare, social determinants of […]

Psychiatric disorder diagnoses and adverse psychiatric outcomes among pregnant and postpartum adolescents in Ontario, Canada: a retrospective, population-based cohort study

Summary Background Adolescents appear to be at increased risk of mental illness during pregnancy and the first year postpartum, although most studies to date are […]

Readmissions Infographic

Preventing avoidable hospital readmissions is considered by many to be the most important opportunity for reducing waste in health care.  The Johns Hopkins ACG® System can […]

Defining and Assessing Geriatric Risk Factors and Associated Health Care Utilization Among Older Adults Using Claims and Electronic Health Records

Abstract Background: Using electronic health records (EHRs), in addition to claims, to systematically identify patients with factors associated with adverse outcomes (geriatric risk) among older […]

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Supporting Clinical Activities

The ACG System UK Team hosts a series of webinars aimed at providing an overview on a number of topics related to risk stratification, population […]

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Predictive Modelling in Action

An introduction to the principles of predictive modeling in health care and examples of how predictive models are being used in the NHS in England. Learn more.

Do physicians who diagnose more mental health disorders generate lower health care costs?

J Fam Pract 49:305-310. University of Rochester School of Medicine, New York, NY, USA BACKGROUND: Underrecognition and undertreatment of mental health disorders in primary care […]

A cross-sectional, population-based study measuring comorbidity among people living with HIV in Ontario

BMC Public Health 14:161. Primary Health Care Research Centre, Bruyère Research Institute, Ottawa, ON, Canada BACKGROUND: As people diagnosed with HIV and receiving combination antiretroviral […]

Health information exchange and the frequency of repeat medical imaging

Am J Manag Care 20:eSP16-24. Weill Cornell Medical College, New York, NY, USA OBJECTIVES: Medical imaging, which is expensive, is frequently repeated for the same […]

Missed strokes using computed tomography imaging in patients with vertigo: population-based cohort study

Stroke 46:108-113. University of Toronto, Toronto, ON, Canada; University Health Network, Toronto, ON, Canada; Institute for Clinical Evaluative Sciences, Toronto, ON, Canada BACKGROUND AND PURPOSE: […]

The effect of pelvic fractures on future stress incontinence and pelvic organ prolapse surgery

Int Urogynecol J Western University, London, ON, Canad INTRODUCTION AND HYPOTHESIS: Pelvic fractures in women significantly disrupt the pelvic floor, which may cause stress urinary […]

Association between metformin use and mortality after cervical cancer in older women with diabetes

Cancer Epidemiol Biomarkers Prev 25:507-512. University Health Network, Toronto, ON, Canada; University of Toronto, Toronto, ON, Canada; Women’s College Hospital, Toronto, ON, Canada; Institute of […]

Effect of specialized diagnostic assessment units on the time to diagnosis in screen-detected breast cancer patients

Br J Cancer 112:1744-1750. Queen’s University, 10 Stuart Street, Kingston, ON, Canada; Cancer Care Ontario, Toronto, ON, Canada; Kingston General Hospital, Kingston, ON, Canada; University […]

Is the association between physical activity and healthcare utilization affected by self-rated health and socio-economic factors?

BMC Public Health 15:737. Lund University, Malmö, Sweden BACKGROUND: Physical activity and healthcare utilization has negative association. However, there appears to be limited knowledge of […]

Full-service family practice in British Columbia: policy interventions and trends in practice, 1991-2010

Healthc Policy 9:32-47. University of British Columbia Vancouver, BC, Canada BACKGROUND: British Columbia’s primary care reform (initiated in 2002) aims to promote “full-service family practice” […]

Risk-adjusted Medicare capitation rates using ambulatory and inpatient diagnoses

Health Care Financ Rev 17:77-99. Johns Hopkins School of Public Health, Baltimore, MD, USA Researchers at The Johns Hopkins University (JHU) developed two new diagnosis-oriented […]

Patient ability and willingness to participate in a web-based intervention to improve hypertension control.

J Med Internet Res 13:e1. Group Health Research Institute, Seattle, WA, USA BACKGROUND: Patient-shared electronic health records provide opportunities for care outside of office visits. […]

Measures of multimorbidity and morbidity burden for use in primary care and community settings: a systematic review and guide

Ann Fam Med 10:134-141. Academic Unit of Primary Health Care, School of Social and Community Medicine, Bristol University, Bristol, UK PURPOSE: Many patients consulting in […]

Development of a risk-adjusted capitation model based on principal inpatient diagnoses in Taiwan

J Formos Med Assoc 102:637-643. Graduate Institute of Health Policy and Management, College of Public Health, National Taiwan University, Taipei, Taiwan BACKGROUND AND PURPOSE: Taiwan’s […]

Use of proton pump inhibitors and risk of osteoporosis-related fractures

CMAJ 179:319-326. Department of Gastroenterology, Division of Internal Medicine, University of Manitoba, Winnipeg, MB, Canada BACKGROUND: The use of proton pump inhibitors has been associated […]

Formal risk adjustment by private employers

Inquiry 38:299-309. Department of Economics, Boston University, Boston, MA, USA This paper explores explanations for why few private employers have adopted formal risk adjustment. The […]

Patient use of secure electronic messaging within a shared medical record: a cross-sectional study

J Gen Intern Med 24:349-355. Group Health Cooperative, Center for Health Studies, Seattle, WA, USA BACKGROUND: Most patients would like to be able to exchange […]

HMO family physicians: men and women differ in their work

HMO Pract 9:155-161. Group Health Cooperative of Puget Sound, Seattle, WA, USA OBJECTIVE: The goal was to identify differences in the type of work and […]

Effect of premium, copayments, and health status on the choice of health plans

Med Care 46:1033-1040. Division of Health Care Policy & Research, Department of Health Sciences Research, Mayo Clinic, Rochester, MN, USA OBJECTIVE: Explore effects of comorbidity […]

Patient sharing among physicians and costs of care: a network analytic approach to care coordination using claims data

J Gen Intern Med 28:459-465. Johns Hopkins University School of Medicine, Baltimore, MD, USA BACKGROUND: Improving care coordination is a national priority and a key […]

Case-mix index and length of hospitalization

G Chir 31:211-214. Published in Italian. Department of Surgical Sciences, Sapienza University of Rome, Italy. The ACG (Adjusted Clinical Groups) case-mix system is a classification […]

ACG case-mix system aids contract assessment, improves performance

Data Strateg Benchmarks 4:21-26. The ABCs of ACGs. Adjusted clinical groups, or ACGs, a risk adjustment system developed by Baltimore-based Johns Hopkins University, are being […]

Realigning incentives in fee-for-service Medicare

Health Aff 22:59-70. Schneider Institute for Health Policy, Brandeis University, Waltham, MA, USA This paper proposes Medicare payment reform built on the fee-for-service system, with […]

Work limitations and their relationship to morbidity burden among academic health center employees with diabetes

Workplace Health Saf 60:425-434. Department of Acute and Chronic Care, John Hopkins University School of Nursing, Baltimore, MD, USA The objective of this study was […]

Population-based trends in osteoporosis management after new initiations of long-term systemic glucocorticoids (1998-2008)

J Clin Endocrinol Metab 97:1236-1242. University of Alberta and University of Alberta Hospital, Edmonton, AB, Canada OBJECTIVES: Our objective was to describe changes in glucocorticoid-induced […]

Ambulatory care casemix measures

J Gen Intern Med 10:162-170. HSR&D Field Program, Edith Nourse Rogers Memorial Veterans Hospital, Bedford, MA, USA No abstract PMID: 7769475

Racial and ethnic differences in utilization of health services in patients with diabetes enrolled in Medicaid

J Health Care Poor Underserved 15:562-575. General Internal Medicine and Health Services Research, UCLA School of Medicine, Los Angeles, CA, USA. We evaluated racial and […]

The effect of acupuncture utilization on healthcare utilization

Med Care 46:41-48. Department of Pharmacy Practice, Albany College of Pharmacy, Research Institute for Health Outcomes, Albany, NY, USA OBJECTIVE: To determine whether acupuncture is […]

A systematic review of health care efficiency measures

Health Serv Res 44:784-805. RAND, Arlington, VA, USA OBJECTIVE: To review and characterize existing health care efficiency measures in order to facilitate a common understanding […]

Achieving cost control, care coordination, and quality improvement in the Medicaid program

J Ambul Care Manage 33:38-49; discussion 69-70. ACS Government Healthcare Solutions, Helena, MT, USA As Medicaid spending rises quickly, controlling cost while coordinating care and […]

Bone microarchitecture assessed by TBS predicts osteoporotic fractures independent of bone density: the Manitoba study

J Bone Miner Res 26:2762-2769. Bone Disease Unit, University of Lausanne, Lausanne, Switzerland The measurement of BMD by dual-energy X-ray absorptiometry (DXA) is the “gold […]

Two-year trends in colorectal cancer screening after switch to a high-deductible health plan

Med Care 49:865-871. Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA, USA BACKGROUND: Recent health reform laws might […]

Postoperative health-care utilization in Crohn’s disease: the impact of specialist care

Am J Gastroenterol 107:1522-1529. Mount Sinai Hospital Centre for Inflammatory Bowel Disease, University of Toronto, Toronto, ON, Canad OBJECTIVES: Crohn’s disease (CD) patients frequently require […]

How does complementary private prescription drug insurance coverage affect seniors’ use of publicly funded medications?

Health Policy 110:147-155. School of Public Policy and Governance, University of Toronto, Toronto, ON, Canada BACKGROUND: Like in many other high-income jurisdictions, the public drug […]

Division of primary care services between physicians, physician assistants, and nurse practitioners for older patients with diabetes

Med Care Res Rev 70:531-541. University of Wisconsin–Madison, WI, USA; University of Pittsburgh School of Pharmacy, Pittsburgh, PA, USA Team-based care involving physician assistants and/or […]

Resources allocation and health care needs in diabetes care in Danish GP clinics

Health Policy 113:206-215. Institute of Public Health, Centre of Health Economics Research, Faculty of Health Sciences, University of Southern Denmark, Odense, Denmark BACKGROUND: In several […]

Measuring medical productivity to gauge the value of Medicare

Minn Med 96:46-48. Department of Finance, Medical Industry Leadership Institute, Carlson School of Management, University of Minnesota, Minneapolis, MN, USA. Having a measure of productivity […]