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Changing patterns of multimorbidity among patients with ambiguous diagnoses: The case of Myalgic Encephalomyelitis/Chronic Fatigue Syndrome

Abstract Introduction Increased attention has been given to multimorbidity. This phenomenon often has been explored through associations between diseases based on the frequency of combinations […]

Association of frailty with perioperative and survival outcomes in patients with gynecologic cancers: A population-based study

Abstract Objectives The relationship between frailty and both short- and long-term outcomes remains underexplored in gynecologic oncology (GO). We sought to evaluate the association of […]

Impact of frailty on outcomes after multiple rib fractures and flail chest undergoing surgical stabilization of rib fractures: a propensity score-matched analysis of the Nationwide Inpatient Sample 2005–2020

Abstract Background This study examined the impact of frailty on in-hospital outcomes in patients undergoing surgical stabilization of multiple rib fractures and flail chest (SSRF). […]

COVID-19 Vaccination, Hospitalization Rates, and Mortality Differ Between People with Diagnosed Immune Mediated Inflammatory Disease and the General Population: A Population-Based Study

Abstract Background: Vaccination reduces Coronavirus disease-19 (COVID-19) infection severity. We evaluated COVID-19 vaccine uptake and effectiveness in people with immune mediated inflammatory diseases (pIMIDs) versus […]

Machine learning identifies clusters of multimorbidity among decedents with inflammatory bowel disease

Abstract Background: Multimorbidity is the co-occurrence of two or more chronic conditions in one person. Providing quality, patient-centered care requires understanding multimorbidity. Our objective was […]

Trends in use of poly (ADP-ribose) polymerase inhibitor (PARPi) in ovarian cancer

Abstract Background To assess population-level trends in use of poly (ADP-ribose) polymerase inhibitors (PARPis) among ovarian cancer patients in the years following initial FDA approvals. […]

Factors Associated With the Receipt of Female Breast Cancer Treatment Among People Living With Intellectual or Developmental Disabilities: A Population-Based Retrospective Cohort Study

ABSTRACT Background People with intellectual or developmental disabilities (IDD) experience breast cancer care inequities relative to those without IDD. Identifying factors associated with receipt of […]

Multimorbidity and Hospital Admissions in High-Need, High-Cost Elderly Patients

Abstract Objective: The aim was to clarify which pairs or clusters of diseases predict the hospital-related events and death in a population of patients with complex […]

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Predictive Modeling Part II

This webinar is a follow up to the previous Predictive Modeling Part I webinar, which provides an overview of the predictive models available within in the […]

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Population Segmentation

Presented by: Sarah Kachur
Director, Population Health R&D, JHHC Business Lead, Pop. Health Precision Medicine

This webinar explores how applying risk taxonomy to a Medicare Advantage population helped a health plan improve their identification of high-risk members.

Sitagliptin use in patients with diabetes and heart failure: a population-based retrospective cohort study

JACC Heart Fail. University of Alberta, Edmonton, AB, Canada OBJECTIVES: The study objective was to evaluate the effects of sitagliptin in patients with type 2 […]

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; VetUnerans Affairs Pittsburgh Healthcare System and University of Pittsburgh School of Pharmacy, Pittsburgh, PA; University of […]

Is use of fall risk-increasing drugs in an elderly population associated with an increased risk of hip fracture, after adjustment for multimorbidity level: a cohort study

BMC Geriatr 14:131. Department of Patient Safety, Blekinge County Council, Karlskrona, Sweden BACKGROUND: Risk factors for hip fracture are well studied because of the negative […]

How do immigrants use primary health care services? A register-based study in Norway

Eur J Public Health 25:72-78. University of Bergen, Norway; Carlos III Health Institute, Madrid, Spain; Aragón Health Sciences Institute (IACS), Zaragoza, Spain; University of Zaragoza, […]

Applying a risk-adjustment framework to primary care: can we improve on existing measures?

Ann Fam Med 1:44-51. Center for Health Quality, Outcomes and Economic Research, VAMC, Bedford, MA, USA Outcome-based performance measurement and prospective payment are common features […]

Analysis of the influence of the process of care in primary health care on avoidable hospitalizations for heart failure

Aten Primaria 48:102-109. Published in Spanish. Hospital Universitario Infanta Sofía, Madrid, España; Unidad Docente Multiprofesional de Atención Familiar y Comunitaria; Madrid, España; Unidad Sistemas de […]

Multimorbidity and its patterns according to immigrant origin. A nationwide register-based study in Norway

PLoS One 10:e0145233. University of Bergen, Bergen, Norway; Norwegian Centre for Minority Health Research, Oslo, Norway; Aragón Health Sciences Institute (IACS), Zaragoza, Spain; Carlos III […]

Impact of language barriers on complications and mortality among immigrants with diabetes: a population-based cohort study

Diabetes Care 38:189-196. University Health Network, Toronto, ON, Canada; Mount Sinai Hospital, Toronto, ON, Canada; Institute for Clinical Evaluative Sciences, Toronto, ON, Canada; St. Michael’s […]

Association between age, gender and multimorbidity level and receiving home health care: a population-based Swedish study

BMC Res Notes 8:714. Lyckeby Primary Healthcare Centre and Blekinge Centre of Competence, Lyckeby, Sweden; University of Southern Denmark, Odense, Denmark BACKGROUND: Home health care […]

Comparing accuracy of risk-adjustment methodologies used in economic profiling of physicians

Inquiry 41:218-231. Department of Health Management and Policy, School of Public Health, University of Michigan, USA This paper examines the relative accuracy of risk-adjustment methodologies […]

Use of a shared medical record with secure messaging by older patients with diabetes

Diabetes Care 33:2314-2319. Department of Medicine, University of Washington, Seattle, WA, USA OBJECTIVE: Evaluate use of a web-based shared medical record (SMR) between older patients […]

Validating the Johns Hopkins ACG Case-Mix System of the elderly in Swedish primary health care

BMC Public Health 6:171. Blekinge Institute for Research & Development, Karlshamn, Sweden BACKGROUND: Individual based measures for comorbidity are of increasing importance for planning and […]

Use of diagnosis-based risk adjustment models to predict individual health care expenditure under the National Health Insurance system in Taiwan

J Formos Med Assoc 104:883-890. Graduate Institute of Health Care Organization Administration, College of Public Health, National Taiwan University, Taipei, Taiwan. BACKGROUND AND PURPOSE: Diagnostic […]

Risk adjustment using administrative data-based and survey-derived methods for explaining physician utilization

Med Care 48:175-182. Institute for Clinical Evaluative Sciences, Toronto, ON, Canada OBJECTIVES: The objective of this study was to evaluate an administrative data-based risk adjustment […]

An in-depth assessment of a diagnosis-based risk adjustment model based on national health insurance claims: the application of the Johns Hopkins Adjusted Clinical Group case-mix system in Taiwan

BMC Med 8:7. Department of Health Policy & Management, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA BACKGROUND: Diagnosis-based risk adjustment is […]

Predicting healthcare costs in a population of Veterans Affairs beneficiaries using diagnosis-based risk adjustment and self-reported health status

Med Care 42:1027-1035. Houston Center for Quality of Care and Utilization Studies, Health Services Research and Development Service, Michael E. DeBakey Veterans Affairs Medical Center, […]

Evaluation of guideline-concordant care for bipolar disorder among privately insured youth

Prim Care Companion J Clin Psychiatry 12:PCC.09m00837. Health Services Research Department, Institute of Psychiatry, King’s College London, London, UK OBJECTIVE: To describe and quantify the […]

Applying population-based case mix adjustment in managed care: the Johns Hopkins Ambulatory Care Group system

Manag Care Q 2:21-34. CSC Healthcare Systems, Inc., Malden, MA, USA When analyzing medical utilization or other health care-related measurements across provider panels, case mix […]

In search of the perfect comorbidity measure for use with administrative claims data: does it exist?

Med Care 44:745-753. Department of Family Medicine, University of Washington, Seattle, WA, USA BACKGROUND: Numerous measures of comorbidity have been developed for health services research […]

The development of Ambulatory Care Groups in primary care

Rev Neurol 29:667-669. Published in Spanish. Fundació Jordi Gol i Gurina, Barcelona, España INTRODUCTION: Ambulatory care groups (ACG) are a system of classification for patients […]

Comparison of private for-profit with private community-governed not-for-profit primary care services in New Zealand

J Health Serv Res Policy 9 Suppl 2:17-22. Department of Public Health, Wellington School of Medicine and Health Sciences, Wellington, New Zealand OBJECTIVE: To compare […]

Costs vs quality in different types of primary care settings

JAMA 272:1903-1908. Department of Health Policy and Management, School of Hygiene and Public Health, Johns Hopkins University, Baltimore, MD, USA OBJECTIVE: To determine the relationship […]

The validity of claims-based risk estimation in underinsured populations

Am J Manag Care 18:e468-e476. Institute for Health and Disability Policy Studies, University of Kansas, Lawrence, KS OBJECTIVES: To demonstrate a threat to validity in […]

The post-fracture care gap among Canadian First Nations peoples: a retrospective cohort study

Osteoporos Int 23:929-936. Department of Medicine, University of Manitoba, 409 Tache Avenue, Winnipeg, MB, Canada Despite targeted attempts to reduce post-fracture care gaps, we hypothesized […]

Taking health status into account when setting capitation rates: a comparison of risk-adjustment methods

JAMA 276:1316-1321. Health Research Center, Institute for Research and Education, HealthSystem Minnesota, Minneapolis, MN, USA OBJECTIVE: To compare performance of different health status measures for […]

Cardiology workforce: a shortage, not a surplus

Health Aff W4:64-66. Mayo Clinic College of Medicine, Rochester, MN, USA The United States faces a serious shortage of cardiologists as our population ages and […]

Adjusted Clinical Groups use as a measure of the referrals efficiency from primary care to specialized in Spain

Eur J Public Health 17:657-663. Planning Management, Badalona Serveis Assistencials, SA, Badalona, Barcelona, Spain BACKGROUND: To determine the referral rate (RR) per centre, its main […]

Medicaid managed care payment rates in 1998

Health Aff 18:217-227. Urban Institute, Washington, DC, USA This paper reports on a new survey of state Medicaid managed care payment rates. We collected rate […]

Chronic care improvement in primary care: evaluation of an integrated pay-for-performance and practice-based care coordination program among elderly patients with diabetes

Health Serv Res 45:1763-1782. Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Johns Hopkins Healthcare LLC, Glen Burnie, MD, USA OBJECTIVE: […]

Implementation of electronic medical records: effect on the provision of preventive services in a pay-for-performance environment

Can Fam Physician 57:e381-e389. Department of Family and Community Medicine, University of Toronto, ON, Canada OBJECTIVE: To study the effect of electronic medical record (EMR) […]

Estimation of chronic co-morbidity on health costs in elderly patients with neurological disorders

Rev Peru Med Exp Salud Publica 28:564-565. Published in Spanish. Directorate of Planning, Badalona Serveis Assistencials SA, Badalona, Spain Sr. Editor. El envejecimiento progresivo de […]

Medical care costs associated with traumatic brain injury over the full spectrum of disease: a controlled population-based study

J Neurotrauma 29:2038-2049. Mayo Clinic, Rochester, MN, USA Data on traumatic brain injury (TBI) economic outcomes are limited. We used Rochester Epidemiology Project (REP) resources […]

The performance of administrative and self-reported measures for risk adjustment of Veterans Affairs expenditures

Health Serv Res 40:887-904. Health Services Research and Development Northwest Center of Excellence, Veterans Affairs Puget Sound Health Care System, Seattle, WA, USA. OBJECTIVE: To […]

Socio-economic position and childhood multimorbidity: a study using linkage between the Avon Longitudinal study of parents and children and the general practice research database

Int J Equity Health 12:66. School of Social and Community Medicine, University of Bristol, Bristol, UK INTRODUCTION: In adults, multimorbidity is associated with social position. […]

Use of risk adjustment in setting budgets and measuring performance in primary care II: advantages, disadvantages, and practicalities

BMJ 323:607-610. School of Public Policy, University College London, London, UK Risk adjustment could help to improve decisions about budgets as well as help measure […]

Prevalence of multimorbidity according to the deprivation level among the elderly in the Basque Country

BMC Public Health 13:918. Oberri, Basque Institute for Healthcare Innovation, Sondika, Spain BACKGROUND: Multimorbidity is clearly a major challenge for healthcare systems. However, currently, its […]

Predictors of colorectal cancer screening variation among primary-care providers and clinics

Am J Gastroenterol 108:1159-1167. University of Wisconsin School of Medicine and Public Health, Madison, WI, USA OBJECTIVES: Colorectal cancer (CRC) screening is underutilized. To effect […]

Antihypertensive medication initiation among young adults with regular primary care use

J Gen Intern Med Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA BACKGROUND: Young adults with hypertension have […]

Systemwide provider performance in a Medicaid program. Profiling the care of patients with chronic illnesses

Med Care 34:798-810. Department of Health Policy and Management, Johns Hopkins University School of Public Health, Baltimore, MD, USA OBJECTIVES: This study illustrates how claims […]

Obesity and co-morbidities in type 2 diabetes: an opportunity to bend the Health Care Cost Curve

Rev Clin Esp 214:140-142. University of Southern Denmark, Odense, Denmark Obesity has long been known as a driver and predictor of the increasing global prevalence […]

Using a health information exchange system for imaging information: patterns and predictors

AMIA Annu Symp Proc 2013:1402-1411. Weill Cornell Medical College, New York, NY, USA Health information exchange (HIE) systems may address the challenges that prevent easy […]

Children and youth with traumatic brain injury: Who uses homecare services, what do they use, and how much does it cost?

First International Conference on Pediatric Acquired Brain Injury, September 2015, Liverpool, UK. University of Toronto, Toronto, ON, Canada Objective: To determine, by sex, the predictors, […]

Women are less likely to be admitted for inpatient rehabilitation after hypoxic-ischemic brain injury

Arch Phys Med Rehabil 96:e17-e18. Toronto Rehabilitation Institute, Toronto, ON, Canada Objective(s): To investigate demographic and acute care clinical determinants  of admission to inpatient rehabilitation […]

Child health and young adult outcomes

J Hum Resources 45:517-548. Columbia University, New York, NY, USA; University of Toronto, Toronto, ON, Canada; University of Manitoba, Winnipeg, MB, Canada Research has shown […]

Patients gain information and skills to improve self-management through innovative tools

Quality Matters December 2010/January 2011. Commonwealth Fund, New York, NY, USA Health reform strategies such as creating patient-centered medical homes depend on an actively engaged […]

What works? A first look at evaluating Manitoba’s regional health programs and policies at the population level

Winnipeg, MB, Canada: Manitoba Centre for Health Policy. Manitoba Centre for Health Policy, University of Manitoba, Winnipeg, MB, Canada Although many descriptive healthcare studies are […]

The New Mexico primary care network

Chapter 5. In: Gavin NI, Farrelly MC, ed. Evaluation of Medicaid managed care programs with 1915(b) waivers. Presented to HCFA Office of R&D. Rockville, MD, […]

Johns Hopkins risk tool used in south

EHI ehealth Insider :5 March 2012. More than 200 GP practices in South Central England are getting quarterly risk stratification and predictive modelling information on […]

Health system use by frail Ontario seniors: an in-depth examination of four vulnerable cohorts

Toronto, ON, Canada: Institute for Clinical Evaluative Sciences. Institute for Clinical Evaluative Sciences, Toronto, ON, Canada Key Findings OLDER WOMEN: A look at gender differences […]

Predicting elderly at risk of increased future healthcare use: how much does diagnostic information add to prior utilization?

Health Serv Outcomes Res Methodology 3:266-277. Adamian Academic Center, Bentley College, Waltham, MA, USA; Center for Health Quality, Outcomes and Economic Research, Veterans Administration Medical […]

Hopkins health pricing tool a managed care hit

Hopkins health pricing tool a managed care hit. Baltimore Business Journal July 21. Baltimore Business Journal, Baltimore, MD, USA Johns Hopkins University’s links with private […]

Event analysis of all-cause and ambulatory care sensitive hospitalization of long-stay nursing home residents

Baltimore, MD, USA: Centers for Medicare and Medicaid Services. Schneider Institutes for Health Policy, The Heller School for Social Policy and Management, Brandeis University, Waltham, […]

Adult obesity in Manitoba: prevalence, associations, and outcomes, 3rd edition

Winnipeg, MB, Canada: Manitoba Centre for Health Policy. Manitoba Centre for Health Policy, Winnipeg, MB, Canada Obesity is a major public health concern in Canada […]

Healthcare expenditure in the last year of life: the experience of South African medical schemes

Cape Town, South Africa: Actuarial Society of South Africa. School of Management Studies, University of Cape Town, Rondebosch, South Africa The aim of this paper […]

Pressupostos e proposta de modelo para a remuneração do trabalho do médico cirurgião nas operadoras de planos de saúde

São Paulo, Brazil: Fundação Getúlio Vargas, Escola de Administração de Empresas de São Paulo (doctoral dissertation). Published in Portuguese. Fundação Getúlio Vargas, Escola de Administração […]

A predictive model to identify patients at risk of unplanned 30-day acute care hospital readmission

In: 2013 IEEE International Conference on Healthcare Informatics, September 9-11, 2013, Philadelphia, PA, USA. Los Alamitos, CA, USA: IEEE:551-556. Department of Health Policy and Management, […]

Central Midlands CSU Case Study

Midlands and Lancashire CSU – ACG® System Case Management Report

Population Health and Resource Allocation Case Study Payer

Slough CCG used data output from the Johns Hopkins ACG System to gain a better understanding of their patient population, understand the factors that drive […]

Population Health Management: A Focus On Analytics Using ACGs

Johns Hopkins HealthCare LLC   Population Health Management: A Focus On Analytics Using ACGs Martha Sylvia, PhD, MBA, RN

Monday(C2)-The Association between Patient Sharing among Physicians and Cost of Care-Lemke

The Association between Patient Sharing among Physicians and Cost of Care-Klaus Lemke

Tuesday(C6)-Do Real Time Clinical Measures Improve the Performance of ACG Based Predictive Models?-Fishman

Do Real Time Clinical Measures Improve the Performance of ACG Based Predictive Models? Paul Fishman, PhD  Robert Reid, MD, PhD 

AcademyHealth 2015 HSR Impact Awardee Summary description of the ACG System

2015 HSR Impact Awardee The Johns Hopkins ACG Case-Mix System

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The ACG System and Care Management

Linda Dunbar, Vice President of Population Health Care Management at Johns Hopkins HealthCare discusses how the ACG System assisted with Care Management for high-risk individuals […]

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Resource Allocation Case Study-Government

The Ministry of Health in Chile used the ACG® System as a risk-adjustment mechanism to improve health care resource allocation and better describe the disease […]

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 […]