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Adjusted Clinical Groups as a risk assessment model for healthcare resource allocation

Rev Med Chil 142:153-160. Published in Spanish. Departamento de Desarrollo Estratégico, Ministerio de Salud. Santiago de Chile BACKGROUND: There is increasing interest in the study […]

Primary health care use from the perspective of gender and morbidity burden

BMC Womens Health 14:145. University of Zaragoza, Zaragoza, Spain; Aragon Health Sciences Institute, Zaragoza, Spain BACKGROUND: Sex and gender can interact to contribute to differences […]

Have we left some behind? Trends in socio-economic inequalities in breastfeeding initiation: a population-based epidemiological surveillance study

Can J Public Health 105:e362. Manitoba Centre for Health Policy, Winnipeg, MB, Canada OBJECTIVES: Breastfeeding is associated with improved health. Surveillance data show that breastfeeding […]

Comorbidity as a predictor of health services utilization and mortality in patients with diabetes

Gac Sanit 29:10-14. Published in Spanish. Universidad de Zaragoza, Zaragoza, España; Dirección General de Planificación y Aseguramiento, Zaragoza, España; Grupo de Investigación en Servicios Sanitarios […]

Patient sharing and quality of care: measuring outcomes of care coordination using claims data

Med Care 53:317-323. Johns Hopkins University, Baltimore, MD, USA BACKGROUND: With the goal of improving clinical efficiency and effectiveness, programs to enhance care coordination are […]

Children’s health care use in the Healthy Kids Program

Pediatrics 100:947-953. Department of Pediatrics, University of Florida, Gainsville, FL, USA BACKGROUND: In 1990, the Florida Legislature established the Florida Healthy Kids Corporation to implement […]

Effect of socioeconomic status on hepatocellular carcinoma incidence and stage at diagnosis, a population-based cohort study

Liver Int. University of Toronto, Toronto, ON, Canada; Cancer Care Ontario, Toronto, ON, Canada; University of British Columbia, Vancouver, BC, Canada; Ontario Institute for Cancer […]

Do pediatric patients who receive care across multiple health systems have higher levels of repeat testing?

Popul Health Manag. Intermountain Healthcare, Salt Lake City, UT, USA; University of Minnesota , Minneapolis, MN, USA; Children’s Hospitals and Clinics of Minnesota , Minneapolis, […]

Are family physicians comprehensively using electronic medical records such that the data can be used for secondary purposes?

A Canadian perspective. BMC Med Inform Decis Mak 15:67. Institute for Clinical Evaluative Sciences, Toronto, ON, Canada; University of Toronto, Toronto, ON, Canada; University Health […]

Relationship between efficiency and clinical effectiveness indicators in an adjusted model of resource consumption: a cross-sectional study

BMC Health Serv Res 13:421. Institut Universitari d’investigació en Atenció Primària Jordi Gol, Barcelona, Spain BACKGROUND: Adjusted clinical groups (ACG®) have been widely used to […]

Renewing primary care: lessons learned from the Spanish health care system

Health Aff 29:1432-1441. Department of Family Medicine at the Alpert Medical School, Brown University, in Providence, RI, USA From 1978 on, Spain rapidly expanded and […]

Risk adjustment alternatives in paying for behavioral health care under Medicaid

Health Serv Res 36:793-811. UCLA Department of Medicine, Los Angeles, CA, USA OBJECTIVE: To compare the performance of various risk adjustment models in behavioral health […]

The interaction of ethnicity and chronic disease as risk factors for osteoporotic fractures: a comparison in Canadian Aboriginals and non-Aboriginals

Osteoporos Int 17:1358-1368. Department of Medicine, University of Manitoba, Winnipeg, MB, Canada INTRODUCTION: Efforts to develop global methods for absolute fracture risk prediction are currently […]

The duration of ambulatory visits to physicians

J Fam Pract 48:264-271. Institute for Health Policy, Massachusetts General Hospital/Partners HealthCare System, Harvard Medical School, Boston, MA, USA BACKGROUND: The objective of our study […]

Factors related to frequent usage of the primary healthcare services in old age: findings from the Swedish National Study on Aging and Care

Health Soc Care Community 17:304-311. Växjö University, School of Social Sciences, Växjö, Sweden People aged 60 or more are the most frequent users of healthcare […]

Health information services technologies

J Ambul Care Manage 19:90-97. ISYS Group, Des Moines, IA, USA Increasing demands for provider profiling have led to the growth of health information services […]

Quantifying morbidities by Adjusted Clinical Group System for a Taiwan population: a nationwide analysis

BMC Health Serv Res 8:153. Department of Medical Affairs and Planning, Taipei Veterans General Hospital, Taipei City, Taiwan, ROC BACKGROUND: The Adjusted Clinical Group (ACG) […]

Case selection for a Medicaid chronic care management program

Health Care Financ Rev 30:61-74. Center for Health Policy and Research, University of Massachusetts Medical School, Shrewsbury, MA, USA Medicaid agencies are beginning to turn […]

Johns Hopkins Ambulatory Care Groups (ACGs). A case-mix system for UR, QA and capitation adjustment

HMO Pract 6:13-19. Johns Hopkins University, Baltimore, MD, USA This paper describes a new ambulatory case-mix system developed at The Johns Hopkins University and known […]

Impact of comorbidities on stroke rehabilitation outcomes: does the method matter?

Arch Phys Med Rehabil 89:1903-1906. Center for Health Quality, Outcomes and Economic Research, Bedford VA Hospital, Bedford, MA, USA OBJECTIVES: To examine the impact of […]

Pay for performance: an excellent idea that simply needs implementation

Qual Manag Health Care 14:31-44. 3M Health Information Systems, Wallingford, CT, USA Pay for performance cannot consist of a one-size-fits-all approach. Variation in quality and […]

Comparative study at 4 health centres of efficiency, measured on the basis of Ambulatory Care Groups

Aten Primaria 38:275-282. Published in Spanish. Badalona Serveis Assistencials, Badalona (Barcelona), España OBJECTIVE: To measure efficiency in the use of resources for the care lists […]

Do Adjusted Clinical Groups eliminate incentives for HMOs to avoid substance abusers? Evidence from the Maryland Medicaid HealthChoice program

J Behav Health Serv Res 30:63-77. UCLA Department of Medicine, Division of General Internal Medicine & Health Services Research, Los Angeles, CA, USA The adequacy […]

Cholecystostomy: a bridge to hospital discharge but not delayed cholecystectomy

J Trauma Acute Care Surg 74:175-179; discussion 179-80. Li Ka Shing Knowledge Institute, St Michael’s Hospital, Toronto, ON, Canada BACKGROUND: Current data on the clinical […]

Primary care safety-net delivery sites in the United States: A comparison of community health centers, hospital outpatient departments, and physicians’ offices

JAMA 284:2077-2083. Department of Health Policy and Management, Johns Hopkins School of Public Health, Baltimore, MD, USA CONTEXT: The US primary care safety net is […]

Psychiatric illness and subsequent traumatic brain injury: a case control study

J Neurol Neurosurg Psychiatry 72:615-620. Department of Psychiatry, University of Washington, Seattle, WA, USA OBJECTIVE: To determine whether psychiatric illness is a risk factor for […]

Population-based medical and disease management: an evaluation of cost and quality

Dis Manag 9:45-55. UMHS Medical Management Center, University of Michigan, Ann Arbor, MI, USA Reports by the Institute of Medicine and the Health Care Financing […]

Regression tree boosting to adjust health care cost predictions for diagnostic mix

Health Serv Res 43:755-772. Healthcare Management and Statistical Consulting, 4303 Stanford Street, Chevy Chase, MD, USA OBJECTIVE: To assess the ability of regression tree boosting […]

The contribution of longitudinal comorbidity measurements to survival analysis

Med Care 47:813-821. Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA, USA BACKGROUND: Many clinical and health services research studies are […]

Income inequities in end-of-life health care spending in British Columbia, Canada: A cross-sectional analysis, 2004-2006

Int J Equity Health 10:12. Centre for Health Services and Policy Research, University of British Columbia, Vancouver BC, Canada BACKGROUND: This study aimed to measure […]

Selection bias explains apparent differential mortality between dialysis modalities

Selection bias explains apparent differential mortality between dialysis modalities. J Am Soc Nephrol 22:1534-1542. University of Calgary, Calgary, AB, Canada The relative risk of death […]

Measuring data reliability for preventive services in electronic medical records

BMC Health Serv Res 12:116. Department of Family and Community Medicine, University of Toronto, Toronto, ON, Canada BACKGROUND: Improvements in the quality of health care […]

Influence of chronic co-morbidity on health costs

Med Clin (Barc) 138:179-180. Published in Spanish. Dirección de Planificación, Badalona Serveis Assistencials, Barcelona, Spain Launched in 1943, Medicina Clínica is a fortnightly journal aimed […]

Comparing measures of multimorbidity to predict outcomes in primary care: a cross sectional study

Fam Pract 30:172-178. Academic Unit of Primary Care, School of Social and Community Medicine, University of Bristol, Bristol, UK BACKGROUND: An increasing proportion of people […]

Productivity and patient satisfaction in primary care — conflicting or compatible goals?

Health Policy 111:157-165. Lund University School of Economics and Management, Lund, Sweden Following recent reforms in Swedish primary care, providers are accountable to both citizens […]

Metformin use and all-cause and prostate cancer-specific mortality among men with diabetes

J Clin Oncol 31:3069-3075. Princess Margaret Hospital, University Health, Toronto, ON, Canada PURPOSE: To evaluate the association between cumulative duration of metformin use after prostate […]

Hospitalizations and emergency department use in Mayo Clinic Biobank participants within the employee and community health medical home

Mayo Clin Proc 88:963-969. Division of Primary Care Internal Medicine, Department of Medicine, Mayo Clinic, Rochester, MN, USA OBJECTIVE: To evaluate the participants in the […]

A model based on age, sex, and morbidity to explain variation in UK general practice prescribing: cohort study

BMJ 337:a238. Department of Statistical Science, University College London, London, UK OBJECTIVE: To examine whether patient level morbidity based measure of clinical case mix explains […]

Can gender difference in prescription drug use be explained by gender-related morbidity? A study on a Swedish population during 2006

BMC Public Health 14:329. Department of Clinical Sciences in Malmö, Center for Primary Health Care Research, Lund University, Malmö, Sweden BACKGROUND: It has been reported […]

Long-term care benefits may reduce end-of-life medical care costs

Popul Health Manag Univita , Natick, MA, USA This study explores whether personal care services for functionally dependent or cognitively impaired individuals paid for by […]

Chapter 4: Effects of multimorbidity on healthcare resource use

In: Mercer SW, Salisbury C, Fortin M, ed. ABC of multimorbidity. Chichester, UK: Wiley:12-16. Haifa University, Haifa, Israel; Johns Hopkins University, Baltimore, MD, USA OVERVIEW […]

ACG-modell kan forutsaga vilka som blir hogkonsumenter av sjukvard

Lakartidningen: Published in Swedish. Health Department, Area Monitoring and Analysis , VästraGotaland, Sweden We describe a method, which uses already existent administrative data to identify […]

Understanding geographic variation in health care costs in British Columbia

Vancouver, BC, Canada: University of British Columbia (doctoral dissertation). University of British Columbia, Vancouver, BC, Canada Amidst concerns about escalating health spending, examining variation in […]

Strategies for assessing health plan performance on chronic diseases: selecting performance indicators and applying health-based risk adjustment

Hamilton, NJ, USA: Center for Health Care Strategies. University of Maryland, Baltimore County, and Johns Hopkins Bloomberg School of Public Health, USA As Medicaid managed […]

Burden of illness in defined populations

Stockholm, Sweden: Karolinska Institute. Karolinska Institute, Stockholm, Sweden This thesis addresses possibilities of describing the burden of illness in a population by elucidating morbidity and […]

Risk assessment of military populations to predict health care cost and utilization

Final report prepared for Center for Health Care Management Studies. RTI Project No. 08490.006. Washington, DC, USA: RTI International and Boston University School of Medicine. […]

The development and testing of risk adjusters using Medicare inpatient and ambulatory data

Final report for Health Care Financing Administration contract 93-026/EE. Falls Church, VA, USA: Lewin Group. Lewin Group, Falls Church, VA, USA The Health Care Financing […]

The Adjusted Clinical Group (ACG) reporting framework

Reporting Framework Subcommittee of the Steering Committee of the Minnesota ACG Users Group. St. Paul, MN, USA: Minnesota ACG Users Group. Minnesota ACG Users Group, […]

Minimal-burden risk adjusters for the Medicare risk program

Medical College of Virginia Associated Physicians, Mathematica Policy Research. Report prepared for the Health Care Financing Review (HCFA Contract No. 17C-90366/3/01). Washington, DC, USA: Mathematica […]

Application of patient safety indicators in Manitoba: a first look.

Winnipeg, MB, Canada: Manitoba Centre for Health Policy. Manitoba Centre for Health Policy, Winnipeg, MB, Canada Although there has always been an interest in patient […]

Analysis of practice variation due to payment methods across health insurance schemes

Khon Kaen, Thailand: Khon Kaen University. There are three public insurance schemes, the non-contributory Civil Servant Medical Benefit  Scheme (CS) for government employees, pensioners and […]

Risk adjustment in a European primary care context: assessing the properties of Adjusted Clinical Groups (ACG) for predictive modeling, for special populations and using ATC pharmacy codes

Baltimore, MD, USA: Johns Hopkins University (doctoral dissertation). Risk adjustment has become an essential tool in modern health services research and management. Specifically, it can […]

Comprehensive care coordination for chronically ill adults

Chapter 5: Intervention components. In: Schraeder C, Shelton PS, ed. Chichester, UK: Wiley-Blackwell:87-126. Care coordination seeks to bridge the gap between the needs of people […]

The association between usual health care utilization and stage at diagnosis in laryngeal cancer

Kingston, ON, Canada: Queen’s University (masters thesis). Queen’s University, Kingston, ON, Canada BACKGROUND: A significant number of laryngeal cancer patients are diagnosed with advanced-stage disease. […]

Adverse selection and inertia in health insurance markets: when nudging hurts

Am Econ Rev 103:2643-2682. University of California, Berkeley, CA, USA This paper investigates consumer inertia in health insurance markets, where adverse selection is a potential […]

Physician-level variation in practice patterns in the VA healthcare system

Health Serv Outcomes Res Methodology 3:95-106. Houston Center for Quality of Care and Utilization Studies, Veterans Affairs Medical Center, Houston, TX, USA; Baylor College of […]

Improve Patient Coordination Through Care Management

Coordinating care and sharing clinical information across the continuum of care has been shown to improve health care outcomes and health care delivery efficiencies. The […]

The Discovery Health experience with the ACG System in South Africa

Discovery Health The Discovery Health experience with the ACG System in South Africa Dr. Dianne Walker

Association between Continuity of Care and Avoidable Hospitalization in Taiwan

Veteran General Hospital – Taipei Continuity of Care and Its Association to Avoidable Hospitalizations of Taiwan’s Veterans: A Preliminary Study Ping Tao, RN., MHA

Wednesday-Closing-Weiner

Johns Hopkins ACG System Future Directions and Opportunities in the Predictive Modeling and Risk Adjustment Fields: The Next 20 Years of the ACG System Jonathon […]

Tuesday-Management implications-Reams

Brown & Toland Physicians Using Risk Adjustment to Measure Access to Primary Care Kam Reams, MPhil, MPH Manager, Performance Improvement

Monday-Leveraging pharmacy data-Bodycombe

Johns Hopkins ACG System Expanded Horizons for Pharmacy Gap Analysis David Bodycombe

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

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.

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.

Rehabilitation of Older Adults with Dementia After Hip Fracture

OBJECTIVES: To evaluate the effects of postoperative rehabilitation on the outcomes of older adults with dementia who experienced hip fracture. DESIGN: Retrospective cohort study. SETTING: […]

Risk of rhabdomyolysis from 5‐α reductase inhibitors

Abstract Purpose: A recent regulatory warning and case reports have described the development of muscle complications with the use of 5‐α reductase inhibitors (5ARIs). We […]

Respiratory health service utilization of children with neuromuscular disease

Abstract Objectives To quantify health service utilization including assessment, monitoring, and treatment of respiratory complications of children with neuromuscular disease (NMD), identifying practice variation and […]

Community palliative care initiatives to reduce end-of-life hospital utilization and in-hospital deaths: A population-based observational study evaluating two home care interventions

Abstract Context The end-of-life period is characterized by increased hospital utilization despite patients’ preferences to receive care and die at home. Objectives To evaluate the […]

Acute vs cumulative benefits of metformin use in patients with type 2 diabetes and heart failure

Abstract   Aims To evaluate the association between metformin use and heart failure (HF) exacerbation in people with type 2 diabetes (T2D) and pre‐existing HF […]

Understanding the impact of a multispecialty electronic consultation service on family physician referral rates to specialists: a randomized controlled trial using health administrative data

Abstract Background Electronic consultation (eConsult) services are secure online applications facilitating provider-to-provider communication. They have been found to improve access to specialist care. However, little […]

Patient-Reported Symptoms Improve Performance of Risk Prediction Models for Emergency Department Visits Among Patients With Cancer: A Population-Wide Study in Ontario Using Administrative Data

Abstract Context Prior work shows measurements of symptom severity using the Edmonton Symptom Assessment System (ESAS) which are associated with emergency department (ED) visits in […]

Epidemiology of Interpersonal Trauma among Women and Men Psychiatric Inpatients: A Population-Based Study

Abstract Objective Small clinical samples suggest that psychiatric inpatients report a lifetime history of interpersonal trauma. Since past experiences of trauma may complicate prognosis and […]

The impact of psychiatric and medical comorbidity on the risk of mortality: a population-based analysis

Abstract Background As life expectancy increases, more people have chronic psychiatric and medical health disorders. Comorbidity may increase the risk of premature mortality, an important […]

In-Hospital Outcomes of Patients on Maintenance Dialysis With Frailty: 10-year Results From the US National Inpatient Sample Database

Abstract Objective The in-hospital mortality rate of patients with end-stage renal disease (ESRD) is 6-8 times greater than that of the general population. A large […]

Overuse or underuse? Use of healthcare services among irregular migrants in a north-eastern Spanish region

Abstract Background There is little verified information on global healthcare utilization by irregular migrants. Understanding how immigrants use healthcare services based on their needs is […]

Health Service Utilization and Costs at the Outset of a Permanent Supportive Housing Program

Abstract Research Questions How do permanent supportive housing (PSH) programs help health systems address the social determinants of health and generate potential cost-savings? What methods […]

Assessing the Impact of Early Identification of Patients Appropriate for Palliative Care on Resource Use and Costs in the Final Month of Life

ABSTRACT Purpose This study evaluates whether an intervention to identify Canadian patients eligible for a palliative approach changes the use of health care resources and […]

Diagnosis of Chronic Hepatitis B Peri‐Complication: Risk factors and Trends over Time

Abstract Background & Aims Hepatitis B virus (HBV) is a major cause of chronic liver disease, which can progress to cirrhosis, hepatocellular carcinoma, and death. […]

Frailty is Independently Associated with Worse Outcomes Following Elective Anatomic Lung Resection

Abstract Background Frailty has been widely recognized as a predictor of postoperative outcomes. Given the paucity of standardized frailty measurements in thoracic procedures, we aimed […]

Multimorbidity networks of chronic obstructive pulmonary disease and heart failure in men and women: Evidence from the EpiChron Cohort

Abstract Objective Patients with heart failure (HF) and/or chronic obstructive pulmonary disease (COPD) constitute a complex population with different phenotypes based on pathophysiology, comorbidity, sex […]

A systematic review of risk stratification tools internationally used in primary care settings

Abstract Background and Aims In our current healthcare situation, burden on healthcare services is increasing, with higher costs and increased utilization. Structured population health management […]

Association Between Exposure of Children to General Anesthesia and Autism Spectrum Disorder

Abstract Objective This study tested the hypothesis that exposure of children prior to their third birthday to procedures requiring general anesthesia is associated with an […]

Periodic screening for breast and cervical cancer in women with diabetes: a population-based cohort study

Abstract Purpose Diabetes is associated with poorer cancer outcomes. Screening for breast and cervical cancer is recommended by clinical guidelines; however, utilization of these tests […]

Cohort study of team-based care among marginalized people who use drugs in Ottawa

Abstract Objective To describe team-based care use among a cohort of people who use drugs (PWUD) and to determine factors associated with receipt of team-based […]

Intellectual/developmental disabilities among people incarcerated in federal correctional facilities in Ontario, Canada: Examining prevalence, health and correctional characteristics

Abstract Background There is little research with people who experience intellectual/developmental disabilities and imprisonment. Methods The study linked health and correctional data to examine prevalence […]

Identifying individuals with complex and long-term health-care needs using the Johns Hopkins Adjusted Clinical Groups System: A comparison of data from primary and specialist health care

Abstract Aims: This study aimed to present the Johns Hopkins Adjusted Clinical Groups (ACG) System risk stratification profile of a total adult population of somatic […]

Association of a Care Coordination Model With Health Care Costs and Utilization The Johns Hopkins Community Health Partnership (J-CHiP)

Abstract Importance  The Johns Hopkins Community Health Partnership was created to improve care coordination across the continuum in East Baltimore, Maryland. Objective  To determine whether the Johns […]

Case Management and Care Coordination Part 1

This webinar will provide an overview of the data available within the ACG System to support case finding activities. The topics covered will include the […]

Case Mix Adjustment in Primary Care

Presented by: Dr. David Shepherd FRCGP

This webinar shares a case study of Leicester CCG in the UK. The ACG System was used to analyze emergency admission rates for all practices in the area. The top 8 practices were identified and studied further to understand key characteristics of those practices.

Developing a dashboard to help measure and achieve the triple aim: a population-based cohort study

BMC Health Serv Res 14:363. McMaster University, Hamilton, ON, Canada BACKGROUND: Health system planners aim to pursue the three goals of Triple Aim: 1) reduce […]

Performance of the ACG case-mix system in two Canadian provinces.

Med Care 39:86-99. Centre for Health Services and Policy Research, University of British Columbia, Vancouver, BC, Canada BACKGROUND: While the adjusted clinical group (ACG) system […]

Identifying possible indicators of systematic overuse of health care procedures with claims data

Med Care 52:157-163. Department of Health Policy and Management, Johns Hopkins University, Baltimore, MD, USA BACKGROUND: Health care quality is frequently described with measures representing […]

Evaluating diagnosis-based case-mix measures: how well do they apply to the VA population?

Med Care 39:692-704. Center for Health Quality, Outcomes and Economic Research, Bedford VAMC, MA, USA BACKGROUND: Diagnosis-based case-mix measures are increasingly used for provider profiling, […]

The association between continuity of care and the overuse of medical procedures

JAMA Intern Med Johns Hopkins University, Baltimore, MD, USA Importance: Both the overuse of unnecessary medical procedures and poor continuity of care are thought to […]

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