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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 […]

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

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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.

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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.

Genetics Consultation Rates Following a Diagnosis of High-Grade Serous Ovarian Carcinoma in the Canadian Province of Ontario

Objective: In 2001, the province of Ontario expanded cancer genetic testing eligibility to include all women with high-grade serous ovarian carcinoma (HGSC) of the ovary, […]

Is case-mix adjustment in primary care at the mercy of coding quality? Yes … and no

BACKGROUND:  Primary care clinicians know that case-mix varies between different physician practices and geographical areas. Leicester City Clinical Commissioning Group (CCG) is now able to quantify […]

Effectiveness of a community care management program for multimorbid elderly patients with heart failure in the Veneto Region

Abstract Background The rapidly growing population of elderly subjects with multimorbidity is at risk of receiving fragmented and uncoordinated care, and have frequent hospitalizations and […]

Population risk and burden of health behavioral–related all-cause, premature, and amenable deaths in Ontario, Canada: Canadian Community Health Survey–linked mortality files

Abstract   Purpose To examine the association of all-cause and premature mortality with four modifiable lifestyle behaviors and quantify the burden of behavioral-related premature death in Ontario, […]

An instrumental variable approach quantifies and confirms the duration of pre-transplant dialysis has negative impact on kidney transplant recipient survival

Abstract Dialysis prior to kidney transplantation may have a detrimental effect on post-transplant Outcomes. However, prior studies have not fully characterized the nature of this […]

Interaction between neighborhood walkability and traffic-related air pollution on hypertension and diabetes: The CANHEART cohort

Abstract Background Living in unwalkable neighborhoods has been associated with heightened risk for diabetes and hypertension. However, highly walkable environments may have higher concentrations of […]

Understanding those overdue for cancer screening by five years or more: A retrospective cohort study in Ontario, Canada

Abstract Populations that are more than just slightly overdue for breast, cervical and colorectal screening should likely be targeted for policy and practice interventions. We […]

Association of Patient, Prescriber, and Region With the Initiation of First Prescription of Biologic Disease-Modifying Antirheumatic Drug Among Older Patients With Rheumatoid Arthritis and Identical Health Insurance Coverage

Abstract Importance Prescribing the first biologic treatment for rheumatoid arthritis (RA) is an important decision for patients, their physicians, and payers, with considerable costs and […]

Multimorbidity patterns in patients with heart failure: an observational Spanish study based on electronic health records

Abstract Objectives To characterise the comorbidities of heart failure (HF) in men and women, to explore their clustering into multimorbidity patterns, and to measure the […]

A Revised Classification Algorithm for Assessing Emergency Department Visit Severity of Populations

ABSTRACT Objectives: Analyses of emergency department (ED) use require visit classification algorithms based on administrative data. Our objectives were to present an expanded and revised version […]

Health care service usage and costs for high-needs elderly patients with heart failure

Abstract Background Heart failure (HF) has been defined as global disease of pandemic proportions, since it affects around 26 million people worldwide.[1] According to a recent […]

Personalized prediction of early childhood asthma persistence: A machine learning approach

Abstract Objective Early childhood asthma diagnosis is common; however, many children diagnosed before age 5 experience symptom resolution and it remains difficult to identify individuals […]

Association Between Surgical Approach and Major Surgical Complications in Patients Undergoing Total Hip Arthroplasty

Abstract Objective To determine whether an anterior approach is associated with lower risk of complications than either a lateral or posterior approach. Design, Setting, and […]

Effect of frailty on postoperative readmissions and cost of care for ovarian cancer

Abstract Objectives Frailty, defined as loss of reserve and vulnerability to changes in health, affects many ovarian cancer patients who are planned to undergo surgery. […]

Healthcare resource utilization in myeloproliferative neoplasms: a population-based study from Ontario, Canada

Abstract Background Health resource utilization (HRU) and associated factors of high cost are not well understood in myeloproliferative neoplasms (MPNs). Methods In this population-based, retrospective […]

Impact of Coronary Artery Severity and Revascularization Prior to Transcatheter Aortic Valve Implantation

Abstract Objective The prevalence of coexisting coronary artery disease (CAD) is high in patients who underwent transcatheter aortic valve implantation (TAVI). Our objective was to […]

Stratifying for Value: An Updated Population Health Risk Stratification Approach

Abstract Objective Most risk stratification approaches attempt to predict clinical outcomes rather than value. For a provider organization or health system to have financial success […]

Kidney Function and Potassium Monitoring After Initiation of Renin-Angiotensin-Aldosterone System Blockade Therapy and Outcomes in 2 North American Populations

Abstract Background: Clinical practice guidelines recommend routine kidney function and serum potassium testing within 30 days of initiating ACE (angiotensin-converting enzyme) inhibitor or angiotensin II […]

Factors Associated With Nonreceipt of Recommended COPD Medications

Abstract Background COPD medications reduce exacerbations and improve quality of life. Despite this, some individuals do not receive medications recommended by practice guidelines. Research Question […]

Performance of quantitative measures of multimorbidity: a population-based retrospective analysis

Abstract Background Multimorbidity measures are useful for resource planning, patient selection and prioritization, and factor adjustment in clinical practice, research, and benchmarking. We aimed to […]

Identifying Complex Patients Using Adjusted Clinical Groups Risk Stratification Tool

ABSTRACT Objectives To produce an efficient and practically implementable method, based on primary care data exclusively, to identify patients with complex care needs who have […]

Validating and Improving Adjusted Clinical Group’s Future Hospitalization and High-Cost Prediction Models for Dutch Primary Care

Abstract The rise in health care costs, caused by older and more complex patient populations, requires Population Health Management approaches including risk stratification. With risk […]

Understanding Data and Opportunities Focused on Value: A Single-Center Experience in Headache Care

Abstract Background and Objectives Headache syndromes are highly prevalent, disabling, and costly. Our goals were to (1) describe headache care delivery and costs in a […]

Mapping Healthcare Needs: A Systematic Review of Population Stratification Tools

Abstract Background and Aim: In 2021, healthcare expenditure in Italy represented 7.3% of the national gross domestic product, with approximately 80% attributed to the management […]

Is the Barthel index a valid tool for patient selection before urological surgery? A systematic review

Background The Barthel Index (BI) measures the level of patient independence in activities of daily living. This review aims to summarize current evidence on the […]

Gaps in the Hepatitis C Prenatal and Postpartum Care Cascade: Rationale for Treatment in Pregnancy

Abstract Background Hepatitis C virus (HCV) infections have increased among younger populations, including pregnant people. While universal screening guidelines have improved case-finding, studies suggest low […]

Social Risk Factors and Their Effect on Health Care Costs in a Midwestern Health Care System

Abstract Objectives: To assess how social risk factors and socioeconomic status (SES) affect health care costs at a large, integrated health system of 45 clinics […]

Access to primary care is associated with improved long-term survival after severe traumatic injury

ABSTRACT BACKGROUND Survivors of severe traumatic injury remain at elevated risk of death in the years after injury. Little is known about how long-term mortality […]

A cross-sectional analysis of staffing, activity, and patient need in general practice in England in 2023: a retrospective cohort study

Abstract Background: General practice in England is experiencing rising demand, workforce diversification, and widening health inequalities. However, there is limited empirical evidence describing how general […]

A population-based study on the impact of social determinants of health on time to treatment of stage I lung cancer in Ontario, Canada

Abstract Background Timely treatment of Stage I non-small cell lung cancer (NSCLC) is essential to improving outcomes, yet disparities persist in access to treatment across […]

Profiling Hospital Performance Based on Mortality After Transcatheter Aortic Valve Replacement in Ontario, Canada

Abstract Background: Public reporting of hospital-level outcomes is increasingly common as a means to target quality improvement strategies to ensure the delivery of optimal care. […]

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Case Management and Care Coordination Part 2

This webinar will provide an introduction to different types of care programs in use to care for patients with existing and emerging risk and the […]

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Provider Profiling and Engagement

Presented by: Dina Goldberg
Executive Director of Population Health, Innovations and Transformation for JHHC

This webinar describes how Johns Hopkins HealthCare (JHHC) uses Provide Profile Reports, created with data from the ACG System, as part of its comprehensive Provider Engagement Strategy.

Association between use of a health information exchange system and hospital admissions

Appl Clin Inform 5:219-231. Weill Cornell Medical College, New York, NY, USA OBJECTIVE: Relevant patient information is frequently difficult to obtain in emergency department (ED) […]

Impact of socio-economic status on breast cancer screening in women with diabetes: a population-based study

Diabet Med 31:806-812. Women’s College Research Institute, Women’s College Hospital, Toronto, ON, Canada AIMS: There is evidence to suggest that mammography rates are decreased in […]

Postoperative medical complications associated with anesthesia in older adults with dementia

J Am Geriatr Soc 62:2102-2109. Queen’s University, Kingston, On, Canada OBJECTIVES: To examine the association between anesthetic technique and postoperative complications in older adults with […]

High-risk case identification for use in comprehensive complex care management

Popul Health Manag 18:15-22. Clalit Health Services, Tel Aviv, Israel The current study aimed to develop a patient selection process for muiltimorbid care management that […]

Paying for primary care: a cross-sectional analysis of cost and morbidity distributions across primary care payment models in Ontario Canada

Soc Sci Med 124:18-28. University of Toronto, Toronto, ON, Canada; Institute for Clinical Evaluative Sciences, Toronto, ON, Canada Policy-makers desire an optimal balance of financial […]

Primary care physician panel size and quality of care: a population-based study in Ontario, Canada

Ann Fam Med 14:26-33. University of Ottawa, Ottawa, ON, Canada; Institute for Clinical Evaluative Sciences, Ottawa, ON, Canada; Institute for Clinical Evaluative Sciences, Toronto, ON, […]

Comorbidity: implications for the importance of primary care in ‘case’ management

Ann Fam Med 1:8-14. Department of Health Policy and Management, Johns Hopkins University, Bloomberg School of Public Health, Baltimore, MD, USA BACKGROUND: Although comorbidity is […]

Classifying physician practice style: a new approach using administrative data in British Columbia

Med Care 53:276-282. University of British Columbia, Vancouver, BC, Canada; Simon Fraser University, Burnaby, BC, Canada; Access Consulting Ltd, Saskatoon, SK, Canada; University of Alberta, […]

Removal or revision of vaginal mesh used for the treatment of stress urinary incontinence

JAMA Surg :1-9. Western University, London, ON, Canada; Institute for Clinical Evaluative Sciences, London, ON, Canada; Hamad Medical Corporation, Doha, Qatar IMPORTANCE: Synthetic mesh slings […]

Post-discharge intervention in vulnerable, chronically ill patients

J Hosp Med 7:124-130. Oregon Health and Sciences University, Portland VA Medical Center, Portland, OR, USA BACKGROUND: Studies suggest that the inpatient to outpatient transition […]

Patient based ‘burden-of-illness’ in Swedish primary health care. Applying the Johns Hopkins ACG case-mix system in a retrospective study of electronic patient records

Int J Health Plann Manage 17:269-282. Centre for Development of Health Services, Stockholm County Council, Sweden Patients from one municipality in Sweden utilizing primary health […]

Development and estimation of a pediatric chronic disease score using automated pharmacy data

Med Care 37:874-883. Center for Health Studies, Group Health Cooperative of Puget Sound, Seattle, WA, USA BACKGROUND: Although risk assessment models for specific adult populations […]

Effectiveness of bone density measurement for predicting osteoporotic fractures in clinical practice

J Clin Endocrinol Metab 92:77-81. Department of Medicine, University of Manitoba, Winnipeg, MB, Canada CONTEXT: Bone density measurement with dual-energy x-ray absorptiometry is widely used […]

The population health approach: health GIS as a bridge from theory to practice

Int J Health Geogr 4:23. Population Health Surveillance Unit, Vancouver Island Health Authority, Victoria, BC, Canada BACKGROUND: The Population Health Approach, proposed by Health Canada, […]

Explanatory ability of the ACG system regarding the utilization and expenditure of the national health insurance population in Taiwan–a 5-year analysis

J Chin Med Assoc 71:191-199. Department of Medical Affairs and Planning, Taipei Veterans General Hospital, Taipei, Taiwan, ROC BACKGROUND: The adjusted clinical group (ACG) is […]

Impact of physician assistant care on office visit resource use in the United States

Health Serv Res 43:1906-1922. Department of Community and Family Medicine, Duke University Medical Center, Durham, NC, USA OBJECTIVE: To investigate whether the use of physician […]

Provider profiling: doing it right

Healthplan 41:74-79. Medstat Group, Washington, DC, USA Managed care plans are a type of health insurance. They have contracts with health care providers and medical facilities […]

Risk of low bone mineral density associated with psychotropic medications and mental disorders in postmenopausal women

J Clin Psychopharmacol 31:56-60. Department of Psychiatry, University of Manitoba, Winnipeg, MB, Canada BACKGROUND: Independent reports suggest that various psychotropic medications and psychiatric disorders are […]

Health reform, health insurance, and mental health care

Am J Psychiatry 169:675-677. Kaiser Commission on Medicaid and the Uninsured, Henry J. Kaiser Family Foundation, Washington, DC; Rollins School of Public Health, Emory University, […]