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Regional variation in healthcare spending and mortality among senior high-cost healthcare users in Ontario, Canada: a retrospective matched cohort study

Abstract Background Senior high cost health care users (HCU) are a priority for many governments. Little research has addressed regional variation of HCU incidence and […]

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Seven Quick Wins (International Version)

Are you a provider, payor or population health organization looking for a quick tune-up to your existing strategy and planning? Then look no further. We […]

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Visualization & Use of the ACG System in the Military Health System

Presented by:David H. Carnahan, Colonel, USAF, MD, MSCE

Relation between surgeon volume and risk of complications after total hip arthroplasty: propensity score matched cohort study

BMJ 348:g3284. University of Toronto, Toronto, ON, Canada; Institute for Clinical Evaluative Sciences, Toronto, ON, Canada OBJECTIVES: To identify a cut point in annual surgeon […]

Mothers of children diagnosed with attention-deficit/hyperactivity disorder: health conditions and medical care utilization in periods before and after birth of the child

Med Care 47:105-114. Division of Research, Kaiser Permanente Medical Care Program, Northern California Region, Oakland, CA, USA BACKGROUND: Analyzing health conditions and medical utilization of […]

Elective, major noncardiac surgery on the weekend: a population-based cohort study of 30-day mortality

Med Care 52:557-564. University of Ottawa, Ottawa, ON, Canada; Ottawa Hospital Research Institute, Ottawa, ON, Canada IMPORTANCE: Previous research has demonstrated that patients undergoing elective […]

Multimorbidity in people with type 2 diabetes in the Basque Country (Spain): Prevalence, comorbidity clusters and comparison with other chronic patients

Eur J Intern Med 26:197-202. Basque Institute for Healthcare Innovation, Barakaldo, Spain; Osakidetza (Basque Health Service), Erandio, Spain; Department of Health, Vitoria-Gasteiz, Spain; World Health […]

Predictors of hospital stay and home care services use: A population-based, retrospective cohort study in stage IV gastric cancer

Palliat Med 29:147-156. Queen’s University, Kingston, ON, Canada; University of Toronto, Toronto, ON, Canada; Institute for Clinical Evaluative Sciences, Toronto, ON, Canada; Queen’s University, Kingston, […]

How profitable is risk selection? A comparison of four risk adjustment models

Health Econ 11:165-174. Department of Health Services, Boston University School of Public Health, Boston, MA, USA To mitigate selection triggered by capitation payments, risk-adjustment models […]

Macrolide antibiotics and the risk of ventricular arrhythmia in older adults

CMAJ Western University, London, ON, Canada; London Health Sciences Centre, London, ON, Canada; Institute for Clinical Evaluative Sciences (ICES) Western, London, ON, Canada BACKGROUND: Many […]

A cross-sectional, population-based study of HIV physicians and outpatient health care use by people with HIV in Ontario

BMC Health Serv Res 15:63. Bruyère Research Institute, Ottawa, ON, Canada; University of Ottawa, Ottawa, ON, Canada; McGill University, Montreal, QC, Canada; Ottawa Hospital Research […]

Improved Survival in Patients with Viral Hepatitis-Induced Hepatocellular Carcinoma Undergoing Recommended Abdominal Ultrasound Surveillance in Ontario: A Population-Based Retrospective Cohort Study

PLoS One 10:e0138907. University of Toronto, Toronto, ON, Canada; Ontario Institute for Cancer Research/Cancer Care Ontario, Toronto, ON, Canada; Institute for Clinical Evaluative  Sciences, Toronto, ON, […]

What, if anything, does amenable mortality tell us about regional health system performance?

Healthc Policy 8:79-90. University of British Columbia, Vancouver, BC, Canada OBJECTIVES: Amenable mortality is proposed as a health system performance measure, and has been used […]

A chronic disease score with empirically derived weights

Med Care 33:783-795. Indiana University Department of Medicine, Indianapolis, IN, USA. Different types of medication prescribed during a 6-month period for the treatment and management […]

Assessing socioeconomic health care utilization inequity in Israel: impact of alternative approaches to morbidity adjustment

BMC Public Health 11:609. Faculty of Social Welfare and Health Sciences, University of Haifa, Mount Carmel, Israel BACKGROUND: The ability to accurately detect differential resource […]

Capitation and enhanced fee-for-service models for primary care reform: a population-based evaluation

CMAJ 180:E72-E81. Institute for Clinical Evaluative Sciences, Toronto, ON, Canada BACKGROUND: Primary care reform in Ontario, Canada, included the initiation of a blended capitation model […]

Variability in prescription drug expenditures explained by Adjusted Clinical Groups (ACG) case-mix: a cross-sectional study of patient electronic records in primary care

BMC Health Serv Res 8:53. Catalan Institute of Oncology, IDIBELL, L’Hospitalet, Barcelona, Spain BACKGROUND: In view of rapidly increasing prescription costs, case-mix adjustment should be […]

The importance of comorbidity in analysing patient costs in Swedish primary care

BMC Public Health 6:36. Ryd Primary Health Care Centre, Linköping, Sweden BACKGROUND: The objective was to explore the usefulness of the morbidity risk adjustment system […]

Designing and using measures of quality based on physician office records.

J Ambul Care Manage 18:56-72. Harvard School of Public Health, Harvard University, Boston, MA, USA This article presents our principles for developing performance measures to […]

Impact of managed care on prescription drug use

Health Aff 10:140-154. Johns Hopkins University School of Hygiene and Public Health, Baltimore, MD, USA Differences between the health services utilization patterns of persons enrolled […]

Socioeconomic status and the utilization of diagnostic imaging in an urban setting

CMAJ 173:1173-1177. Radiology, University of Manitoba, Winnipeg, MB, Canada INTRODUCTION AND HYPOTHESIS: An inverse relationship exists between socio-economic status (SES) and osteoporotic fractures. In publicly […]

Rural American Indian Medicaid health care services use and health care costs in California

Am J Public Health 96:363-370. Institute for Health Policy Studies, University of California San Francisco, USA OBJECTIVES: We determined differences in Medicaid service use and […]

Evaluating diagnosis-based risk-adjustment methods in a population with spinal cord dysfunction

Arch Phys Med Rehabil 85:218-226. OBJECTIVE: To examine performance of models in predicting health care utilization for individuals with spinal cord dysfunction.DESIGN: Regression models compared […]

Oil and water? Lessons from Maryland’s effort to protect safety net providers in moving to Medicaid managed care

J Urban Health 77:645-662. Mathematica Policy Research in Washington, DC, USA Studies have highlighted the tensions that can arise between Medicaid managed care organizations and […]

Does community-governed nonprofit primary care improve access to services? Cross-sectional survey of practice characteristics

Int J Health Serv 35:465-478. Department of Public Health, Wellington School of Medicine and Health Sciences, New Zealand This study compared community-governed nonprofit and for-profit […]

Predictors of 1-year change in patient activation in older adults with diabetes mellitus and heart disease

J Am Geriatr Soc 60:1316-1321. Group Health Research Institute, Seattle, Washington, USA OBJECTIVES: To identify patterns and predictors of 1-year change in patient activation in […]

Risk-adjusted resource allocation: using Taiwan’s National Health Insurance as an example

Asia Pac J Public Health 27:NP958-971. Department of Health Policy & Management, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA. OBJECTIVES: To […]

Distance to hospital and socioeconomic status influence secondary health care use

Scand J Prim Health Care 31:83-88. Blekinge Centre of Competence, Karlskrona, Sweden Objective. The aim of this study was to investigate how distance to hospital […]

The effect of the doctor-patient relationship on emergency department use among the elderly

Am JPublic Health 90:97-102. Department of Family Medicine, University of Washington School of Medicine, Seattle, WA, USA OBJECTIVES: This study sought to determine the rate […]

Measurement of relative cost weights as an effect of the retrospective application of Adjusted Clinical Groups in primary care

Gac Sanit 20:132-141. Published in Spanish. Badalona Serveis Assistencials, S.A., Badalona, Barcelona, España OBJECTIVE: The objective of the study is to obtain the cost’s relative […]

Income-related inequities: Cross-sectional analyses of the use of medicare services in British Columbia in 1992 and 2002

Open Med 2:e91. University of British Columbia, Vancouver, BC, Canada BACKGROUND: The primary demonstration of the principle of income-related equity in Canada is the provision […]

Disaster-related injuries in the period of recovery: the effect of prolonged displacement on risk of injury in older adults

JTrauma 67:834-840. Department of Environmental Health Sciences, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA BACKGROUND: Hurricane Katrina, which struck the Gulf Coast […]

Setting health care capitations through diagnosis-based risk adjustment: a suitable model for the English NHS?

Health Policy 101:133-139. Faculty of Health, University of Plymouth, Plymouth, UK The English system of health resource allocation has been described as the apotheosis of […]

Insurance coverage and subsequent utilization of complementary and alternative medicine providers

Am J Manag Care 12:397-404. Department of Health Services, School of Public Health and Community Medicine, University of Washington, Seattle, WA, USA BACKGROUND: Since 1996, […]

Multimorbidity, polypharmacy, referrals, and adverse drug events: are we doing things well?

Br J Gen Pract 62:e821. Aragón Health Sciences Institute (IACS), Miguel Servet University Hospital, University of Zaragoza, Spain BACKGROUND: The consequences of multimorbidity include polypharmacy […]

Costs and associated factors with optimal and suboptimal responses to the treatment of major depressive disorder

Aten Primaria 44:667-675. Published in Spanish. Dirección de Planificación, Badalona Serveis Assistencials, Barcelona, Spain OBJECTIVE: To evaluate the compliance, persistence and costs of the treatment […]

Factors associated with hospitalisations for ambulatory care-sensitive conditions among persons with an intellectual disability: a publicly insured population perspective

J Intellect Disabil Res 57:226-239. Dual Diagnosis Program, Centre for Addiction and Mental Health, Toronto, ON, Canada BACKGROUND: Hospitalisations for ambulatory care-sensitive (ACS) conditions are […]

Cardiovascular safety of inhaled long-acting bronchodilators in individuals with chronic obstructive pulmonary disease

JAMA Intern Med 173:1175-1185. Institute for Clinical Evaluative Sciences, Toronto, ON, Canada; Department of Medicine, Sunnybrook Health Sciences Centre, Toronto, ON, Canada; Child Health Evaluative […]

The disconnect between better quality of glucocorticoid-induced osteoporosis preventive care and better outcomes: a population-based cohort study

J Rheumatol 40:1736-1741. University of Alberta, Edmonton, AB, Canada; University of Manitoba, Winnipeg, MB; McGill University, Montreal, QC, Canada OBJECTIVE: The quality of glucocorticoid-induced osteoporosis […]

Glucagonlike peptide 1-based therapies and risk of hospitalization for acute pancreatitis in type 2 diabetes mellitus: a population-based matched case-control study

JAMA Intern Med 173:534-539. Department of Medicine, Johns Hopkins University Schools of Medicine and Public Health, Baltimore, MD, USA IMPORTANCE: Acute pancreatitis has significant morbidity […]

The association between obesity and outpatient visits for acute respiratory infections in Ontario, Canada

Int J Obes 38:113-119. Institute for Clinical Evaluative Sciences, Toronto, ON, Canada; Public Health Ontario, Toronto, ON, Canada; University of Toronto, Toronto, ON, Canada OBJECTIVE: […]

Effects of impairment in activities of daily living on predicting mortality following hip fracture surgery in studies using administrative healthcare databases

BMC Geriatr 14:9. Queen’s University, Kingston, ON, Canada BACKGROUND: Impairment in activities of daily living (ADL) is an important predictor of outcomes although many administrative […]

Variation in inpatient hospital prices and outpatient service quantities drive geographic differences in private spending in Texas

Health Serv Res. University of Texas School of Public Health, Houston, TX, USA OBJECTIVE: To measure the contribution of market-level prices, utilization, and health risk […]

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

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

Physician integrated network: a second look

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

Putting your faith in data

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

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

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

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

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

Employer purchasing coalitions and Medicaid: experiences with risk adjustment

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

Clinical and economic features of categories of patients in defined populations

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

Use predictive modeling to improve profitability under cap

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

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

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

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

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

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

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

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

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

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

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

Disparities in antipsychotic medication use

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

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

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

Who is in our hospitals … and why?

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

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

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

ACG System Predictive Models Overview

This document provides a high-level overview of how the predictive models within the Johns Hopkins Adjusted Clinical Groups® (ACG) System are designed and the factors […]

Morbidity Burden in Persons with Multiple Chronic Conditions

Morbidity Burden in persons with Multiple Chronic Conditions and Identification of inequitable resource use in Israel Dr. Efrat Shadmi Faculty of Social Welfare and Health […]

Application of ACGs to Medical Claim Records in Japan

Tokyo Medical and Dental University Application of the ACG System to Medical Claim Records in Japan Koichi Kawabuchi

Tuesday-Utilization-Chang

Johns Hopkins ACG System Consistent High Users: Characteristics and Identification Hsien-Yen Chang, PhD. Research Associate

Tuesday-Keynote III-Weiner

Johns Hopkins ACG System Risk Adjustment and Predictive Modeling in Health Reform Jonathan Weiner

Monday-Care Coordination I-Pollack

Johns Hopkins ACG System Innovations in Measuring and Managing Care Coordination Craig Pollack, MD, MHS

The future of integrated care in the NHS

The King’s Fund The Future of Integrated Care in the NHS Professor Chris Ham Chief Executive  

Monday(P1)-A New Day in Population Health Management: Innovations in Risk Adjustment and Predictive Modeling-Weiner

A New Day in Population Health Management: Innovations in Risk Adjustment and Predictive Modeling Welcome and Opening Remarks  Jonathan P. Weiner, DRPH Professor and CEO […]

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Reducing Readmissions

Is your hospital or health system interested in reducing readmissions? Turning data points into actionable insights is key to understanding and addressing the drivers of readmission rates. Learn more in this step-by-step instructional video.

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: […]

Evaluating an insurer-based health coaching program: Impact of program engagement on healthcare utilization and weight loss

Abstract Insurers and employers are increasingly offering lifestyle and weight-loss coaching programs; however, few evaluations have examined their effectiveness. Our objectives were to determine whether […]

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Population Health Profiling

This webinar will explore how the ACG System can – and is – being used to support commissioners and those responsible for the management of […]

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Risk adjusted resource allocation in Sweden

Presented by:Andreas Johansson, M.Sc., Founder of Ensolution

Comparison of health care needs of child family members of adults with alcohol or drug dependence versus adults with asthma or diabetes

J Dev Behav Pediatr 35:282-291. Division of Research, Kaiser Permanente Northern California, Oakland, CA, USA OBJECTIVE: To compare the health problems, preventive care utilization, and […]