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Albuminuria, Reduced Kidney Function, and the Risk of ST‐ and non–ST‐segment–elevation myocardial infarction

Abstract Background Chronic kidney disease is a recognized independent risk factor for cardiovascular disease, but whether the risks of ST‐segment–elevation myocardial infarction (STEMI) and non–ST‐segment–elevation […]

Correlation between Potentially Inappropriate Medication and Alzheimer’s Disease among the Elderly

Abstract   Purpose This study is conducted to explore the association between potentially inappropriate medication (PIM) and Alzheimer’s disease (AD) among the elderly. Methods We […]

Variation in the health outcomes associated with frailty among home care clients: relevance of caregiver distress and client sex

Abstract Background The identification of contextual factors that modify associations between client frailty and their health and service use outcomes is essential for informed home […]

The Incremental Health Care Costs of Frailty Among Home Care Recipients With and Without Dementia in Ontario, Canada: A Cohort Study

Abstract Objective In this study, we investigated the incremental 1-year direct costs of health care associated with frailty among home care recipients in Ontario with and without […]

Do Incentive Payments Reward The Wrong Providers? A Study Of Primary Care Reform In Ontario, Canada

ABSTRACT Primary care payment reform in the US and elsewhere usually involves capitation, often combined with bonuses and incentives. In capitation systems, providing care within […]

Economic Analysis of Adjuvant Chemoradiotherapy Compared with Chemotherapy in Resected Pancreas Cancer

Abstract Background Population-based survival and costs of pancreas adenocarcinoma patients receiving adjuvant chemoradiation and chemotherapy following pancreaticoduodenectomy are poorly understood. Methods This retrospective cohort study used […]

Incremental healthcare utilisation and costs among new senior high-cost users in Ontario, Canada: a retrospective matched cohort study

Abstract Objectives To describe healthcare use and spending before and on becoming a new (incident) senior high-cost user (HCU) compared with senior non-HCUs; to estimate […]

Diagnostic accuracy of administrative codes for autosomal dominant polycystic kidney disease in clinic patients with cystic kidney disease

Abstract Background The ability to identify patients with autosomal dominant polycystic kidney disease (ADPKD) and distinguish them from patients with similar conditions in healthcare administrative […]

Correlates of non-adherence to breast, cervical, and colorectal cancer screening among screen-eligible women: a population-based cohort study in Ontario, Canada

Abstract Purpose Breast, cervical, and colorectal cancers are cancers that can be detected early through screening. Despite organized cancer screening programs in Ontario, Canada participation […]

Comparing the Predictive Effects of Patient Medication Adherence Indices in Electronic Health Record and Claims-Based Risk Stratification Models

Abstract Multiple indices are available to measure medication adherence behaviors. Medication adherence measures, however, have rarely been extracted from electronic health records (EHRs) for population-level […]

In-Person and Telehealth Ambulatory Contacts and Costs in a Large US Insured Cohort Before and During the COVID-19 Pandemic

Abstract Importance This study assesses the role of telehealth in the delivery of care at the start of the COVID-19 pandemic. Objectives To document patterns […]

Class III Obesity and Other Factors Associated with Longer Wait Times for Endometrial Cancer Surgery: A Population-Based Study

Abstract Objective To evaluate the impact of class III obesity (body mass index >40 kg/m2) on wait times for endometrial cancer surgery in Ontario, as […]

Evaluating the performance of a predictive modeling approach to identifying members at high-risk of hospitalization

Abstract Aims To evaluate the risk-of-hospitalization (ROH) models developed at Blue Cross Blue Shield of Louisiana (BCBSLA) and compare this approach to the DxCG risk-score […]

Impact of Area Deprivation Index on the Performance of Claims-Based Risk-Adjustment Models in Predicting Health Care Costs and Utilization

Abstract Objective Traditionally, risk-adjustment models do not address the characteristics of minority populations, such as race or socioeconomic status. This study aimed to evaluate the […]

Long-term risk of subsequent major osteoporotic fracture and hip fracture in men and women: a population-based observational study with a 25-year follow-up

Abstract Summary The risk of subsequent major osteoporotic and hip fracture following an initial fracture was increased in both sexes over 25 years, with modest […]

Association of Surgical Experience With Risk of Complication in Total Hip Arthroplasty Among Patients With Severe Obesity

Abstract Importance Severe obesity is a risk factor for major early complications after total hip arthroplasty (THA). Objective To determine the association between surgeon experience […]

Outpatient Physical Therapy Use Following Tibial Fractures: A Retrospective Commercial Claims Analysis

Abstract Objective The purpose of this study was to characterize outpatient physical therapy (OPT) use following tibial fractures and examine the variability of OPT attendance, […]

Time since prior fracture affects mortality at the time of clinical assessment: a registry‑based cohort study

Abstract Summary Fractures are associated with increased long-term mortality in patients surviving to undergo baseline DXA. Notably, excess mortality risk does not decline with increasing […]

Impact of Frailty on Hospital Outcomes Among Patients with Lymphoid Malignancies Receiving Autologous Hematopoietic Stem Cell Transplantation in the United States

Abstract Background Frailty could affect outcomes of autologous hematopoietic stem cell transplantation (aHSCT). This study sought to examine the effects of frailty on hospital outcomes […]

Relationship of frailty with excess mortality during the COVID-19 pandemic: a population-level study in Ontario, Canada

Abstract Background There is a paucity of the literature on the relationship between frailty and excess mortality due to the COVID-19 pandemic. Methods The entire […]

Combining Patient Survey Data With Diagnosis Codes Improved Medicare Advantage Risk-Adjustment Accuracy

Abstract Under the current Medicare Advantage (MA) risk-adjustment system, plans are incentivized to report diagnosis codes on enrollees’ medical claims reflecting additional and more severe […]

Primary Care Unattachment; Impact on Mortality, Hospitalizations and Costs

Abstract Background: Primary care attachment, defined as a patient’s formal or informal affiliation with a regular primary care provider, is a cornerstone of many healthcare […]

Trends in Insulin Out-of-Pocket Costs and Use Disparities, 2008-2021

Abstract OBJECTIVE: To assess trends in insulin out-of-pocket (OOP) costs, use, and disparities among commercially insured patients from 2008 to 2021. STUDY DESIGN: Retrospective time […]

Refocusing Algorithmic Fairness on Feature-Level Bias: A Diagnostic Approach Using Dutch EHR Data

Abstract While algorithmic fairness research in healthcare has predominantly focused on disparities in model performance, less attention has been given to the underlying data structures […]

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Risk Stratification with only EHR Data – White Paper

Risk stratification models have traditionally used medical and pharmacy claims data combined with other sources, such as electronic health records (EHRs).  But provider organizations often […]

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Reducing Emergency Department Use

People usually go to the Emergency Department (ED) when they are experiencing a medical emergency. But some people choose the ED for non-urgent care, which […]

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Case Mix Measurement

This webinar provides an introduction to the principle of case mix and the constructs within the ACG System that make this possible. This session is a […]

Applications of the ACG System in the UK

This white paper provides an overview of the ACG System and how it is being used to support a range of clinical and commissioning activities […]

Physician referral rates: style without much substance?

Med Care 38:836-846. Department of Family Medicine, University of Rochester, New York, NY, USA BACKGROUND: Primary care physicians (PCPs) exhibit widely varying referral rates, resulting […]

Constructing ”behavioral” comparison groups: a difference-in-difference analysis of the effect of copayment based on the patient’s price elasticity

Eval Health Prof 37:434-456. National Kaohsiung First University of Science and Technology, Kaohsiung, Taiwan It is well known that the differences-in-differences (DD) estimator is based […]

Revisiting the economic efficiencies of observation units

Manag Care 24:46-52. University of Texas, Houston, TX, USA; Michael E. DeBakey Veterans Affairs Medical Center HSR&D, Houston, TX, USA; Baylor College of Medicine, Houston, […]

Profiling resource use: do different outcomes affect assessments of provider efficiency?

Am J Manag Care 8:1105-1115. Center for Health Quality, Outcomes and Economic Research, Bedford Veterans Affairs Medical Center, Bedford, MA, USA OBJECTIVES: To examine whether […]

The case for case-mix adjustment in practice profiling. When good apples look bad

JAMA 272:871-874. Harvard Community Health Plan, Brookline, MA, USA OBJECTIVE: To assess the influence of patient characteristics on practice profiling. Using the example of specialty […]

The patient-centered medical home and associations with health care quality and utilization: a 5-year cohort study

Ann Intern Med 164:395-405. Weill Cornell Medical College, New York, NY, USA BACKGROUND: Effects of the patient-centered medical home (PCMH) are unclear. Previous studies had […]

Association between electronic health records and health care utilization

Appl Clin Inform 6:42-55. Weill Cornell Medical College, New York, NY, USA BACKGROUND: The federal government is investing approximately $20 billion in electronic health records […]

Indication for pharmacological treatment is often lacking: a cross-sectional study on the quality of drug therapy among the elderly

BMC Geriatr 15:117. Lund University, Malmö, Sweden; Stanford University School of Medicine, Stanford, CA, USA; University of Southern Denmark, Odense C, Denmark BACKGROUND: Although the […]

Infliximab in ulcerative colitis: the impact of preoperative treatment on rates of colectomy and prescribing practices in the province of British Columbia, Canada

Dis Colon Rectum 57:83-90. University of British Columbia, Vancouver, BC, Canada BACKGROUND: Approximately 20% of patients with ulcerative colitis will require surgical treatment. Recent data […]

Effect of practice variation on resource utilization in infants hospitalized for viral lower respiratory illness.

Pediatrics 108:851-855. University of Virginia Children’s Medical Center, Charlottesville, Virginia, USA OBJECTIVE: Hospital care for children with viral lower respiratory illness (VLRI) is highly variable, […]

Benefits and pitfalls in applying the experience of prepaid group practices to the U.S. physician supply

Health Aff W4:73-75. Center for Health Workforce Studies, School of Public Health, University at Albany, State University of New York, Rensselaer, NY, USA The paper […]

Does a diagnosis of schizophrenia reduce rates of mammography screening? A Manitoba population-based study

Schizophr Res 113:95-100. Department of Psychiatry, University of Manitoba, CancerCare Manitoba, Winnipeg, MB, Canada It is estimated that mammography screening can reduce mortality from breast […]

Using multiple data features improved the validity of osteoporosis case ascertainment from administrative databases.

J Clin Epidemiol 61:1250-1260. Manitoba Centre for Health Policy, University of Manitoba, Winnipeg, MB, Canada OBJECTIVES: The aim was to construct and validate algorithms for […]

Risk adjustment in health insurance exchanges for individuals with mental illness

Am J Psychiatry 169:704-709. Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA OBJECTIVE: In 2014, an estimated […]

Prevalence of health problems and primary care physicians’ specialty referral decisions

J Fam Pract 50:427-432. Health Services Research and Development Center, Department of Health Policy and Management, Johns Hopkins School of Hygiene and Public Health, Baltimore, […]

Early dropout from psychotherapy for depression with group- and network-model therapists

Adm Policy Ment Health 39:440-447. Group Health Research Institute, Seattle, WA, USA Administrative data were used to examine early dropout among 16,451 health plan members […]

Using the Johns Hopkins Aggregated Diagnosis Groups (ADGs) to predict mortality in a population-based cohort of adults with schizophrenia in Ontario, Canada

Psychiatry Res 196:32-37. Institute for Clinical Evaluative Sciences, University of Toronto, Toronto, ON, Canad Administrative health care databases are increasingly used for health services and […]

Multimorbidity patterns in primary care: interactions among chronic diseases using factor analysis

PLoS One 7:e32190. IIS Aragón, Aragón Health Sciences Institute, Miguel Servet University Hospital, University of Zaragoza, Zaragoza, Spain OBJECTIVES: The primary objective of this study […]

The effect of capitation on switching primary care physicians

Health Serv Res 38:191-209. University of Rochester School of Medicine and Dentistry, Department of Community and Preventive Medicine, Rochester, NY, USA OBJECTIVE: To examine the […]

How well do Ambulatory Care Groups predict expenditures on mental health and substance abuse patients?

Adm Policy Ment Health 24:339-357. Department of Health Care Policy, Harvard Medical School, Boston, MA, USA This paper evaluates the ability of Ambulatory Care Groups […]

Stratification of the population in the Basque Country: results in the first year of implementation

Aten Primaria 45:54-60. Published in Spanish. Instituto Vasco de Innovación Sanitaria, Sondika, Bizkaia, Spain Predictive models allow populations to be stratified according to their health […]

Triumph of hope over experience: learning from interventions to reduce avoidable hospital admissions identified through an Academic Health and Social Care Network

BMC Health Serv Res 12:153. Department of Health Care Management and Policy, University of Surrey, Guildford, UK BACKGROUND: Internationally health services are facing increasing demands […]

Comorbidity-based payment methodology for Medicaid enrollees with HIV/AIDS

Health Care Financ Rev 23:53-68. Center for Health Program Development and Management, University of Maryland Baltimore County, Baltimore, MD, USA Managed care organizations (MCOs) may […]

Monitoring the prevalence of chronic conditions: which data should we use?

BMC Health Serv Res 12:365. Osakidetza, Basque Health Service, C/ Alava n° 45, Vitoria-Gazteiz, Spain BACKGROUND: Chronic diseases are an increasing threat to people’s health […]

Effect of patient socioeconomic status on physician profiles for prevention, disease management, and diagnostic testing costs

Med Care 40:717-724. Department of Family and Community Medicine, University of California School of Medicine, Davis, CA, USA BACKGROUND: Previous research shows patient socioeconomic status […]

Medical and pharmacy expenditures after implementation of a cyclooxygenase-2 inhibitor prior authorization program

Pharmacotherapy 25:924-934. Medical and Pharmacy Integration Services, Prime Therapeutics, LLC, Eagan, MN, USA STUDY OBJECTIVE: To evaluate the effects of a cyclooxygenase (COX)-2 inhibitor prior […]

The MMPI-2: a contemporary normative study of midwestern family medicine outpatients

J Clin Psychol Med Settings 15:98-119. Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN, USA For more than 60 years it has been known […]

Relationships between physical activity and perceived qualities of life in old age

Results of the SNAC study. Aging Ment Health 13:1-8. School of Social Science, Vaxjo University, Vaxjo, Sweden OBJECTIVES: The aim of the present study was […]

Impact of morbidity, resource use and costs on maintenance of remission of major depression in Spain: a longitudinal study in a population setting

Gac Sanit 24:13-19. Published in Spanish. Dirección de Planificación, Badalona Serveis Assistencials S.A., Badalona, Barcelona, Spain OBJECTIVE: To determinate the impact of comorbidity, resource use […]

A population-based study of the association between socioeconomic status and emergency department utilization in Ontario, Canada

Acad Emerg Med 18:836-843. Division of Emergency Medicine, Department of Medicine, Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada OBJECTIVES: The […]

Complementary and alternative medicine provider use and expenditures by cancer treatment phase

Am J Manag Care 14:326-334. Department of Health Services, School of Public Health and Community Medicine, University of Washington, Seattle, WA, USA OBJECTIVE: To assess […]

A comparison of health care use for physician-referred and self-referred episodes of outpatient physical therapy

Health Serv Res 47:633-654. Center for Public Health Statistics, University of Iowa, Iowa City, IA, USA OBJECTIVE: To compare patient profiles and health care use […]

A population-based description of atrial fibrillation in the emergency department, 2002 to 2010

Ann Emerg Med 62:570-577. Institute for Clinical Evaluative Sciences, Toronto, ON, Canada; Division of Emergency Medicine, Department of Medicine, University of Toronto, Toronto, ON, Canada; […]

Preeclampsia as a risk factor for diabetes: a population-based cohort study

PLoS Med 10:e1001425. Department of Medicine, University of Toronto, Toronto, ON, Canada BACKGROUND: Women with preeclampsia (PEC) and gestational hypertension (GH) exhibit insulin resistance during […]

Vaccine effectiveness against laboratory-confirmed influenza hospitalizations among elderly adults during the 2010-2011 season

Clin Infect Dis 57:820-827. Institute for Clinical Evaluative Sciences, Toronto, ON, Canada BACKGROUND: Although annual influenza immunization is recommended for adults aged ≥65 years due […]

Morbidity and costs associated to neurological disorders

Neurologia 28:126-129. Directorate of Planning, Badalona Serveis Assistencials SA, Badalona, Spain La presencia de múltiples enfermedades es frecuente en edades avanzadas, y diferentes estudios poblacionales […]

Pneumococcal vaccine targeting strategy for older adults: Customized risk profiling

Vaccine 32:990-995. Clalit Research Institute, Tel Aviv, Israel BACKGROUND: Current pneumococcal vaccine campaigns take a broad, primarily age-based approach to immunization targeting, overlooking many clinical […]

Prevalence and costs of multimorbidity by deprivation levels in the Basque country: a population based study using health administrative databases

PLoS One 9:e89787. Basque Health Service, Erandio, Bizkaia, Spain; Basque Institute for Healthcare Innovation, Sondika, Bizkaia, Spain; Universidad Complutense de Madrid, Madrid, Spain; Australian National […]

A qualitative study on clinicians’ perceptions about the implementation of a population risk stratification tool in primary care practice of the Basque Health Service

BMC Fam Pract 15:150. Basque Institute for Healthcare Innovation, Bizkaia, Spain BACKGROUND: A prospective Population Risk Stratification (PRS) tool was first introduced in the public […]

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 […]

Efficiency assessment of primary care providers: a conditional nonparametric approach

Eur J Operational Res 240:235-244. Universidad de Extremadura, Badajoz, Spain; Basque Institute for Healthcare Innovation, Sondika, Spain; Osakidetza, Basque Health Service, Erandio, Spain This paper […]

The Ontario MedsCheck Diabetes pharmacist medication review service: a descriptive analysis of service recipients between 2010-2014 using administrative claims data

Canadian Association for Population Therapeutics Conference, November 2015, Toronto, ON, Canada. A MedsCheck Diabetes (MCD) consultation is a pharmacist-led medication review service funded by the […]

Population-level costs and resource utilization of homecare for persons with Alzheimer’s disease

J Popul Ther Clin Pharmacol 21:pe120. Background: The aging population in Ontario is accompanied by an increased incidence and prevalence of Alzheimer’s disease (AD). Given […]

Working well – the Texas demonstration to maintain independence and employment: 18-month outcomes

Journal of Vocational Rehabilitation 34:97-106. Addiction Research Institute, Center for Social Work Research, University of Texas at Austin, Austin, TX, USA Uninsured working adults with […]

Chronic conditions and co-morbidity among residents of British Columbia

Centre for Health Services and Policy Research, University of British Columbia. Centre for Health Services and Policy Research, University of British Columbia, Vancouver, BC, Canada […]

Using health research in policy and practice: case studies from nine countries

New York, NY, USA: Academy Health/Milbank Memorial Fund. Academy Health/Milbank Memorial Fund, New York, NY, USA As the move toward an evidence-based approach to health […]

Description, behavior, use and methodology used to measure case mix in our primary health care system: the Ambulatory Care Groups (ACGs)

Barcelona, Spain: Fundacio Salut, Empresa i Economia. Published in Spanish. Fundacio Salut, Empresa i Economia, Barcelona, Spain No abstract

Analysing performance of primary health care using the ACG case-mix system

Malmo, Sweden: Lund University (doctoral dissertation). Lund University, Malmo, Sweden The overall aim of this thesis was to analyse the importance of co-morbidity level for […]

The epidemiology and outcomes of critical illness in Manitoba

Winnipeg, MB, Canada: Manitoba Centre for Health Policy. Manitoba Centre for Health Policy, Winnipeg, MB, Canada This report was conducted at the Manitoba Centre for […]

Addition of pharmacy cost data improves performance of the Adjusted Clinical Groups predictive model for total health care costs overall and within disease specific groups

Value in Health 7:371. AdvancePCS, Hunt Valley, MD, USA OBJECTIVE: To determine the effect of adding the pharmacy cost data option to the Adjusted Clinical […]

Burden of morbidity in a patient perspective – the case of sick-leave certified patients in primary care

BMC Public Health 9:157. Data on morbidity in Sweden are based on numbers of diagnoses, classified by the WHO system, the International Statistical Classification of […]

Using risk adjustment approaches in child welfare performance measurement: applications and insights from health and mental health settings

Child Youth Serv Rev 32:103-112. Washington University in St. Louis, St. Louis, MO, USA Federal policymaking in the last decade has dramatically expanded performance measurement […]

Predicting the financial risks of seriously ill patients

Sacramento, CA, USA: California Health Care Foundation. In this paper, a Medical Productivity Index (MPI) is proposed as such a metric to capture the value […]

Empirical studies in the economics of health insurance, health, and fertility

Princeton, NJ, USA: Princeton University (doctoral dissertation) Princeton University, Princeton, NJ, USA This thesis is a collection of essays in the economics of health insurance, […]

A simple but efficient approach to the analysis of multilevel data

Health Economics Papers 2013:6. Odense, Denmark: University of Southern Denmark. University of Southern Denmark, Odense, Denmark Much research in health economics revolves around the analysis […]

Adjusted clinical groups: a patient classification system through risk adjustment

Rev Peru Med Exp Salud Publica 30:308-314. Published in Spanish. Directorate of Planning, Badalona Serveis Assistencials SA, Badalona, Spain Adjusted Clinical Groups (ACG) are risk […]

High-Risk Case Identification for Use in Comprehensive Complex Care Management

 High-Risk Case Identification for Use in Comprehensive Complex Care ManagementBecause patients with multiple chronic conditions require proactive, coordinated care management to effectively manage numerous health […]

Population Health Management through Care Coordination and Interventions

Population health management at JHHC represents a comprehensive approach to health care considering the distribution of health outcomes within a population, and the health determinants […]

Casemix and Quality

Hospital Authority Casemix and Quality – Are they rivals or partners? Dr. K.H. Lee

Tuesday-Managing hospitalization risk-Terry and Oberg

Dovetail Managing Hospitalization Risk: Refining Patient Selection in a Care Transitions Program Lara Terry, MD. Jeff Oberg

Monday-US Health Reform-Abrams

Johns Hopkins ACG System Using ACGs to Support Risk Adjusted Premiums within the Health Insurance Exchange Chad Abrams

Monday-Advances in modeling risk-Thibodeau

Medica Leveraging the John Hopkins ACG Tool to Support Total Cost of Care Contracts Peter M. Thibodeau

Implementing the ACG risk within NHS

NHS Airedale, Bradford & Leeds Cluster Information Services Implementing the ACG risk of hospitalization model with NHS data: experiences from Leeds Dr Thomas Mason MA., […]

Using Predictive Modeling to Identify Readmission Risk

Johns Hopkins Bloomberg School of Public Health Using Predictive Modeling to Identify Readmission Risk K. Lemke

Monday(C3)-Geographically Identifying Expanded Diagnosis Clusters in the Hispanic/Latino Population —Thomas Ludden

Geographically Identifying Expanded Diagnosis Clusters in the Hispanic/Latino Population  —Thomas Ludden, Carolinas Healthcare System  

Wednesday(C9)-Swinging from a new tee – towards ‘The Extended Epidemiology’ by analysing the outcome from ACG processing in a County Council in Sweden

Swinging from a new tee – towards ‘The Extended Epidemiology’ by analysing the outcome from ACG processing in a County Council in Sweden —Ulf Börjesson, […]

Care Density: Amy Salls, DST Health Solutions

ACG System DST Health Solutions Care Density Amy Salls

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The ACG System as a Common Language

Chad Abrams, Director of U.S. Operations, ACG System; describes common challenges around the world such as language differences, data quality, turning data into impact, and […]

Incident atrial fibrillation in the emergency department in Ontario: a population-based retrospective cohort study of follow-up care

CMAJ Open 3:E182. Institute for Clinical Evaluative Sciences, Toronto, ON, Canada; University of Toronto, Toronto, ON, Canada BACKGROUND: Continuity of care has been shown to […]

Comprehensive preventive care assessments for adults with intellectual and developmental disabilities in Ontario – Part 2: 2003-2014

Objective To determine if there has been an increase in preventive care among adults with IDD as a result of the publication of the Canadian […]

Association between method of pelvic organ prolapse repair involving the vaginal apex and re-operation: a population-based, retrospective cohort study

Abstract Introduction and hypothesis Vaginal apical suspension is essential for the surgical treatment of pelvic organ prolapse (POP). We aim to evaluate whether the method […]