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Evaluation of alternative diagnosis based risk adjustment models and morbidity trajectories for application in Taiwan

Baltimore, MD, USA: Johns Hopkins University (doctoral dissertation). Department of Health Policy and Management, Johns Hopkins University, Baltimore, MD, USA OBJECTIVE: The overall goals of […]

Hospitalizations for ambulatory care sensitive conditions among persons with an intellectual disability,

Manitoba, 1999-2003. Toronto, ON, Canada: University of Toronto (doctoral dissertation). University of Toronto, Toronto, ON, Canada This thesis examines hospitalizations for ambulatory care sensitive conditions […]

Nursing home adverse events: further insight into highest risk periods

Journal of the American Medical Directors Association 12:467-474. University of Manitoba, Winnipeg, MB, Canada INTRODUCTION: Adverse events (AEs) occur frequently in nursing homes (NHs). Although […]

The feasibility of an outpatient casemix classification system based on the health insurance database in Thailand

Health Systems Research Institute and Alliances :Published in Thai. The objective of this study was to examine the feasibility of an outpatient casemix classification system […]

Comparing the costs and use of services for military care in military and civilian facilities

Orlando, FL, USA: AcademyHealth Annual Research Meeting. NORC at the University of Chicago, Bethesda, MD, USA RESEARCH OBJECTIVE: The objective is to compare the cost […]

The association between metformin therapy and mortality following breast cancer: a population-based study

Toronto, ON, Canada: University of Toronto (masters thesis). University of Toronto, Toronto, ON, Canada Metformin has been associated with a reduction in breast cancer incidence, […]

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 […]

Association of Suicidality and Depression With 5α-Reductase Inhibitors

IMPORTANCE There have been concerns raised by patients and regulatory agencies regarding serious psychiatric adverse effects associated with 5α-reductase inhibitors. OBJECTIVE To determine if there […]

Estimates and predictors of health care costs of esophageal adenocarcinoma: a population-based cohort study

Background Esophageal adenocarcinoma (EAC) incidence is increasing rapidly. Esophageal cancer has the second lowest 5-year survival rate of people diagnosed with cancer in Canada. Given […]

Equilibria in Health Exchanges: Adverse Selection versus Reclassification Risk

Abstract This paper studies regulated health insurance markets known as exchanges, motivated by the increasingly important role they play in both public and private insurance […]

Impact of stratification on the effectiveness of a comprehensive patient‐centered strategy for multimorbid patients

Abstract Objective The objective of this work was to assess the effectiveness of a population‐level patient‐centered intervention for multimorbid patients based on risk stratification for […]

Physician procedure volume and related adverse events after surgically induced abortion: a population-based cohort study

Abstract   BACKGROUND Induced abortion is a common procedure performed by physicians with varying degrees of clinical experience. We aimed to determine whether a physician’s […]

A comparison of population segmentation methods

Abstract This paper presents the first comparison of descriptive segmentation methods for population health management. The aim of descriptive segmentation is to identify heterogeneous segments […]

Determinants of vaccination uptake, and influenza vaccine effectiveness in preventing deaths and hospital admissions in the elderly population; Treviso, Italy, 2014/2015-2016/2017 seasons

ABSTRACT Seasonal influenza is an important cause of morbidity and mortality, particularly among the elderly population. Determinants of vaccination uptake and its impact on health […]

Colonoscopy resource availability and its association with the colorectal cancer diagnostic interval: A population-based cross-sectional study

Abstract BACKGROUND Colonoscopy is a key resource used to diagnose colorectal cancer (CRC). This study evaluated the relationship between colonoscopy availability and the length of […]

A systematic review of case-mix models for home health care payment: Making sense of variation

Abstract Background Case-mix based payment of health care services offers potential to contain expenditure growth and simultaneously support needs-based care provision. However, limited evidence exists […]

Assessing guideline-concordant care for patients with multimorbidity treated in a care management setting

Abstract   Background Disease-specific guidelines are not aligned with multimorbidity care complexity. Meeting all guideline-recommended care for multimorbid patients has been estimated but not demonstrated […]

Factors associated with waiting time to breast cancer diagnosis among symptomatic breast cancer patients: a population-based study from Ontario, Canada

Abstract Purpose A prolonged time from first presentation to cancer diagnosis has been associated with worse disease-related outcomes. This study evaluated potential determinants of a […]

Assessment of the Adjusted Clinical Groups system in Dutch primary care using electronic health records: a retrospective cross-sectional study

Abstract Background Within the Dutch health care system the focus is shifting from a disease oriented approach to a more population based approach. Since every […]

Association of perioperative red blood cell transfusions with all-cause and cancer-specific death in patients undergoing surgery for gastrointestinal cancer: Long-term outcomes from a population-based cohort

Abstract Background Red blood cell transfusions are common in patients undergoing gastrointestinal cancer surgery. Yet, to adequately balance their risks and benefits, clinicians must understand […]

Incidence of Access to Ambulatory Mental Health Care Prior to a Psychiatric Emergency Department Visit Among Adults in Ontario, 2010-2018

Abstract Importance Psychiatric emergency department (ED) visits may be avoidable if individuals have access to adequate outpatient care, but the extent to which individuals use […]

Healthcare utilization in patients with higher-risk MDS/low-blast count AML treated with azacitidine in the ‘real-world’

Abstract Background Despite the adoption of azacitidine (AZA) in higher-risk MDS/low-blast count AML, limited ‘real-world’ data on resource utilization and toxicity exist. Methods We linked […]

Association between Dysphagia and Surgical Outcomes across the Continuum of Frailty

Abstract Objective This study examined the relationship between dysphagia and adverse outcomes across frailty conditions among surgical patients ≥50 years of age. Methods A retrospective cohort […]

Allopurinol adherence, persistence and patterns of use in individuals with diabetes and gout: A retrospective, population-based cohort analysis

Abstract Objective There has been growing interest in the potential role for allopurinol to reduce cardiovascular events in people with diabetes. While adherence to allopurinol is poor […]

Multimorbidity Patterns in the General Population: Results from the EpiChron Cohort Study

Abstract Objective The correct management of patients with multimorbidity remains one of the main challenges for healthcare systems worldwide. In this study, we analyze the […]

Assessing the Value of Unsupervised Clustering in Predicting Persistent High Health Care Utilizers: Retrospective Analysis of Insurance Claims Data

Abstract Background A high proportion of health care services are persistently utilized by a small subpopulation of patients. To improve clinical outcomes while reducing costs […]

Impact of a high-risk multimorbidity integrated care implemented at the public health system in Chile

Abstract During recent years, multimorbidity has taken relevance because of the impact of causes in the system, people, and their families, which has been a […]

A bias evaluation checklist for predictive models and its pilot application for 30-day hospital readmission models

Abstract Objective Health care providers increasingly rely upon predictive algorithms when making important treatment decisions, however, evidence indicates that these tools can lead to inequitable […]

Latent Class Analysis of Social Needs in Medicaid Population and Its Impact on Risk Adjustment Models

Abstract Background: A growing number of US states are implementing programs to address the social needs (SNs) of their Medicaid populations through managed care contracts. […]

Differences in use of telemedicine integrated into traditional primary health care – a comparative observational study

Abstract Telemedicine in primary health care is expected to address many of the issues currently challenging service delivery. However, the impact and effect will depend […]

Prevalence and predictors of potentially inappropriate prescribing using codified STOPP-START and Beers criteria: a retrospective cohort study in Ontario’s older population

Abstract Objectives To quantify potentially inappropriate prescribing (PIP) and assess the association between patient characteristics and PIP using previously coded STOPP-START and Beers criteria in […]

Patterns of Telehealth Use Across the Cancer Care Continuum and Assessment of Patient and Geographic Factors Associated With Key Healthcare Outcomes: Retrospective Study

Abstract Background: Although the use of telehealth has declined since the pandemic, it remains a popular mode of care delivery across the cancer care continuum. […]

COVID-19 immunisation among individuals with opioid use disorder in Ontario: a population-based cohort study

Abstract Background The COVID-19 pandemic exacerbated health inequities, particularly among individuals with opioid use disorder (OUD). Disparities in vaccine uptake among people with OUD remain […]

Association between COVID-19 vaccination and sudden death in apparently healthy younger individuals: A population-based case-control study

Abstract Background COVID-19 vaccines can cause rare but serious adverse events such as myocarditis and immune thrombocytopenia. Despite a lack of strong evidence, concerns have […]

Opioid Use During Pregnancy among Individuals with Disabilities

ABSTRACT Introduction To investigate (1) prevalence and time trends in opioid use during pregnancy and (2) patterns of opioid use before and during pregnancy, among […]

Clinical and sociodemographic characteristics of limited and persistent uveitis cases: a population-based study

Abstract Objective To compare the clinical and sociodemographic characteristics of limited and persistent uveitis cases and temporal trends in incidence in Ontario. Methods A retrospective […]

Abstract Introduction: We aimed to compare the effectiveness of methadone and sublingual buprenorphine/naloxone and their association with treatment discontinuation using real-world data from Ontario, Canada. […]

Effect of periodic health exam on provider management of preventive services

Abstract Rationale and objective To evaluate the relationship between receipt of annual physicals and the receipt of provider recommendation for preventive services, during a period […]

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Using Additional Data Sets

This webinar explores the use of data sets from other Health and Social Care providers with the ACG system.In particular, it will focus on Sollis’s […]

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Inter-Relationship Between Frailty & Multimorbidity

Presented by: Alan Thompson, MSc
Director of User Support, ACG System

Whilst it is true that resource use increases with an increasing degree of frailty, this presentation will demonstrate that not all frail patients are high cost and not all high cost patients are frail.

The excess medical cost and health problems of family members of persons diagnosed with alcohol or drug problems

Med Care 45:116-122. Division of Research, Kaiser Permanente Northern California, Oakland, CA, USA BACKGROUND: Having a family member with substance use problems affects family functioning, […]

Is socioeconomic status associated with utilization of health care services in a single-payer universal health care system?

Int J Equity Health 13:115. Ben-Gurion University, Beer Sheva, Israel; Clalit Health Services, Tel Aviv, Israel OBJECTIVES: To assess an association of Socio-economic status with […]

Validation of 2 new measures of continuity of care based on year-to-year follow-up with known providers of health care

Ann Fam Med 12:559-567. Montreal Health and Social Services Agency, Montreal, QC, Canada PURPOSE: In a primary care context favoring group practices, we assessed the […]

The healthy migrant effect in primary care

Gac Sanit 29:15-20. Aragón Health Sciences Institute (IACS), Zaragoza, Spain; University of Zaragoza, Zaragoza, Spain; Miguel Servet University Hospital, Zaragoza, Spain; Carlos III Health Institute, […]

Medication oversupply in patients with diabetes

Res Social Adm Pharm 11:382-400. Veterans Affairs Pittsburgh Healthcare System, Pittsburgh, PA, USA; University of Pittsburgh, PA, USA; University of Wisconsin, Madison, WI, USA; Pharmacy […]

Prognostic factors in metastatic gastric cancer: results of a population-based, retrospective cohort study in Ontario

Gastric Cancer 19:150-159. Department of Surgery, Maimonides Medical Center, Brooklyn, NY, USA BACKGROUND: Stage IV gastric cancer is lethal, and little population-based research on prognostic […]

The temporal risk of heart failure associated with adjuvant trastuzumab in breast cancer patients: a population study

J Natl Cancer Inst 108:10. University of Toronto, Toronto, ON, Canada; St. Michael’s Hospital, Toronto, ON, Canada; Institute for Clinical Evaluative Sciences, Toronto, ON, Canada; […]

The origin of variation in primary care process and outcome indicators: patients, professionals, centers, and health districts

Medicine 94:e1314. Centro de Salud de Astrabudua (Primary Health Care Center of Astrabudua), Osakidetza (Basque Health Service), Erandio (Bizkaia), Spain; Primary Care Research Unit-Bizkaia, Osakidetza, […]

Characteristics of physicians and patients who join team-based primary care practices: evidence from Quebec’s Family Medicine Groups

Health Policy 116:264-272. McGill University, Montreal, QC, Canada; Direction de la santé publique de l’Agence de la Santé et des services sociaux de Montréal, Montreal, […]

Adjusted Clinical Groups Method (ACG) to allocate resources according to the disease burden of each health center

Santelices C E, Muñoz P F, Muñiz P, Rojas J. BACKGROUND: Health care must be provided with strong primary health care models, emphasizing prevention and a […]

Determining the morbidity profile, health-service utilization and health-provider efficiency in the Rejang River Basin, Sarawak, based on TPC® data and the Johns Hopkins ACG® System

BMC Health Serv Res 10:A8. Ministry of Health, Malaysia; Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA Introduction: The study focused on the […]

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 […]