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Development and validation of the Cambridge Multimorbidity Score

Abstract BACKGROUND Health services have failed to respond to the pressures of multimorbidity. Improved measures of multimorbidity are needed for conducting research, planning services and […]

Frailty is highly prevalent in specific cardiovascular diseases and females, but significantly worsens prognosis in all affected patients: A systematic review

Abstract Objective Cardiologists are more often confronted with older (>60 years) cardiovascular disease (CVD) patients. These patients have particular needs in clinical care because, for […]

Multimorbidity and chronic diseases among undocumented migrants: evidence to contradict the myths

Abstract Background There is little verified information on the global health status of undocumented migrants (UMs). Our aim is to compare the prevalence of the […]

Impact of Neighborhood Social and Environmental Resources on Medicaid Spending

Abstract Introduction In an era of COVID-19, Black Lives Matter, and unsustainable healthcare spending, efforts to address the root causes of health are urgently needed. […]

Development of measurable criteria to identify and prioritize patients for inclusion in comprehensive medication management programs within primary care settings

ABSTRACT BACKGROUND Pharmacists optimize medication use and ensure the safe and effective delivery of pharmacotherapy to patients using comprehensive medication management (CMM). Identifying and prioritizing […]

Emergency department use and hospital admission in children following ambulatory surgery: a retrospective population-based cohort study

ABSTRACT Introduction Paediatric ambulatory surgery (same day surgery and planned same day discharge) is more frequently being performed more in Canada and around the world; […]

Opioid Use after Nephrectomy for Kidney Cancer in Ontario: A Population-Based Study

Abstract Objective To compare the odds of early and prolonged post-operative opioid use in patients undergoing minimally invasive surgery (MIS) versus open surgery for nephrectomy. […]

Evaluating the predictive value of comorbidity indices in pituitary surgery: a mixed-effects modeling study using the Nationwide Readmissions Database

Abstract OBJECTIVE Although pituitary adenomas (PAs) are common intracranial tumors, literature evaluating the utility of comorbidity indices for predicting postoperative complications in patients undergoing pituitary […]

Using the Johns Hopkins ACG Case-Mix System for population segmentation in a hospital-based adult patient population in Singapore

Abstract Objective Population health management involves risk characterisation and patient segmentation. Almost all population segmentation tools require comprehensive health information spanning the full care continuum. […]

Population risk stratification tools and interventions for chronic disease management in primary care: a systematic literature review

Abstract Background Population risk stratification (RS) tools have been proposed to tailor interventions, prioritize resources, and proactively manage high-risk individuals with chronic diseases in primary […]

Enhancing Depression Identification and Stratification with a Claims-Based Analytical Framework

Abstract Depression, a prevalent health condition, substantially impacts both socioeconomic outcomes and individual wellbeing. Despite the availability of diagnostic tools, existing approaches for identifying depression […]

Association of frailty with outcomes of patients undergoing transvenous lead removal for cardiac implantable electronic device infections in the United States

Abstract Background Frailty, marked by reduced physiological resilience, is associated with adverse outcomes in patients undergoing various cardiovascular procedures. The rising incidence of cardiac implantable […]

Evaluating an insurer-based health coaching program: Impact of program engagement on healthcare utilization and weight loss

Abstract Insurers and employers are increasingly offering lifestyle and weight-loss coaching programs; however, few evaluations have examined their effectiveness. Our objectives were to determine whether […]

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Population Health Profiling

This webinar will explore how the ACG System can – and is – being used to support commissioners and those responsible for the management of […]

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Risk adjusted resource allocation in Sweden

Presented by:Andreas Johansson, M.Sc., Founder of Ensolution

Comparison of health care needs of child family members of adults with alcohol or drug dependence versus adults with asthma or diabetes

J Dev Behav Pediatr 35:282-291. Division of Research, Kaiser Permanente Northern California, Oakland, CA, USA OBJECTIVE: To compare the health problems, preventive care utilization, and […]

Prevalence of depression in adults with type 2 diabetes in the Basque Country: relationship with glycaemic control and health care costs

BMC Public Health 14:769. Basque Institute for Healthcare Innovation, Barakaldo, Spain BACKGROUND: The aim of the study was to estimate the prevalence of depression in […]

Data resource profile: Pathways to Health and Social Equity for Children (PATHS Equity for Children)

Int J Epidemiol 43:1438-1449. Manitoba Centre for Health Policy, Winnipeg, MB, Canada The PATHS Data Resource is a unique database comprising data that follow individuals […]

Incidence of severe hypoglycaemic episodes in patients with type 2 diabetes in the Basque country: impact on healthcare costs

BMC Health Serv Res 15:207. Basque Institute for Healthcare Innovation, Barakaldo, Spain; Osakidetza, Basque Health Service, Erandio, Spain; University of Deusto, Bilbao, Spain BACKGROUND: Hypoglycaemia […]

Variability in potentially preventable hospitalisations: an observational study of clinical practice patterns of general practitioners and care outcomes in the Basque Country (Spain)

BMJ Open 5:e007360. Osakidetza Basque Health Service, Erandio, Bizkaia, Spain; University of Deusto, Bilbao, Spain OBJECTIVES: To explain the variability in the frequency of potentially […]

Outcomes among patients discharged from the emergency department with a diagnosis of peripheral vertigo

Ann Neurol 79:32-41. University of Toronto, Toronto, ON, Canada; Sunnybrook Health Sciences Centre, Toronot, ON, Canada; Institute of Health Policy, Management and Evaluation at the […]

Evaluation of an innovative program to improve outcomes among military beneficiaries with diabetes

Nurs Econ 33:271-280. University of Texas at Tyler, Tyler, TX, USA; Texas A&M University Health Science Center, Bryan, TX, USA Patients with Type 2 Diabetes […]

Health administrative data can be used to define a shared care typology for people with HIV

J Clin Epidemiol 68:1301-1311. Bruyère Research Institute, Ottawa, ON, Canada; University of Ottawa, Ottawa, ON, Canada; Institute for Clinical Evaluative Sciences, Ottawa, ON, Canada; Ottawa […]

Trends in relative survival in patients with a diagnosis of hepatocellular carcinoma in Ontario: a population-based retrospective cohort study

CMAJ Open 3:E208-E216. University of Toronto, Toronto, ON, Canada; Ontario Institute for Cancer Research/Cancer Care Ontario, Toronto, ON, Canada; Institute for Clinical Evaluative Sciences, Toronto, […]

Prevalence and costs of chronicity and multimorbidity in the population covered by the Basque public telecare service

An Sist Sanit Navar 36:429-339, Published in Spanish. Centro de Salud Astrabudua, Erandio, Spain BACKGROUND: The public telecare service in the Basque Autonomous Community (betiON) […]

Medication, diagnostic, and cost information as predictors of high-risk patients in need of care management

Am J Manag Care 15:41-48. Department of Pediatrics, Children’s Hospital of Philadelphia, Philadelphia, PA, USA OBJECTIVE: To contrast the advantages and limitations of using medication, […]

Preventive screening of women who use complementary and alternative medicine providers

J Womens Health 18:1133-1143. Department of Health Services, School of Public Health and Community Medicine, University of Washington, Seattle, WA, USA BACKGROUND: Many women use […]

Explaining prescription drug use and expenditures using the Adjusted Clinical Groups case-mix system in the population of British Columbia, Canada

Med Care 48:402-408. Centre for Health Services and Policy Research, University of British Columbia, School of Population and Public Health, Vancouver, BC, Canada BACKGROUND: Given […]

Methods of reducing the financial risk of physicians under capitation

Arch Fam Med 8:149-155. Johns Hopkins Center for Hospital Finance and Management, Baltimore, MD, USA. In today’s rapidly changing medical marketplace, managed care plans are […]

Use of well-child visits in high-deductible health plans

Am J Manag Care 16:833-840. Center for Child Health Care Studies, Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, […]

Risk adjustment for people with chronic conditions in private sector health plans

Med Decis Making 23:397-405. The MEDSTAT Group, Inc., Washington, DC, USA BACKGROUND: Although the problem of adverse selection into more generous health insurance plans has […]

Ambulatory care practice variation within a Medicaid program

Health Serv Res 30:751-770. Johns Hopkins University, School of Public Health, Department of Health Policy and Management, Baltimore, MD, USA STUDY QUESTIONS: What is the […]

Tamoxifen use and osteoporotic fracture risk: a population-based analysis

J Clin Oncol 26:5227-5232. CancerCare Manitoba, Winnipeg, MB, Canada PURPOSE: Although tamoxifen has been shown to increase bone mineral density in clinical trials, it is […]

Patient race/ethnicity and shared medical record use among diabetes patients

Med Care 50:434-440. Center for Vulnerable Populations, University of California, San Francisco, CA, USA BACKGROUND: Previous studies have documented racial/ethnic differences in patients’ use of […]

Distribution of primary care expenditure according to sex and age group: a retrospective analysis

Aten Primaria 44:145-152. Published in Spanish. Centre d’Atenció Integral Dos de Maig, Consorci Sanitari Integral, Barcelona, Spain; Dirección de Planificación y Desarrollo Organizativo, Badalona Serveis […]

Ambulatory encounter systems: implications for payment and quality

J Ambul Care Manage 16:33-49. Many key decision makers are looking to AESs solely for purposes of payment. This approach is unfortunate because many systems […]

Identification of pharmacy cost outliers in primary care

Aten Primaria 41:453-459. Published in Spanish. Instituto Aragonés de Ciencias de la Salud, Zaragoza, España OBJECTIVE: To identify pharmacy cost outlier patients in Primary Care, […]

Impact of deductibles on initiation and continuation of psychotherapy for treatment of depression

Health Serv Res 47:1561-1579. Group Health Research Institute and University of Washington, Seattle, WA, USA OBJECTIVE: To estimate the impact of deductibles on the initiation […]

Ambulatory care sensitive hospitalizations and emergency visits: experiences of Medicaid patients using federally qualified health centers

Med Care 39:551-561. MDS Associates, Wheaton, MD, USA BACKGROUND: Federally Qualified Health Centers (FQHCs) serve as regular sources of preventive and primary care for low-income […]

Health-risk-assessment tools used to predict costs in defined populations

J Healthc Inf Manag 14:31-57. Vanderbilt University Medical Center, Nashville, TN, USA With the Balanced Budget Act of 1997 mandating that the Health Care Financing […]

Comparison of risk adjusters for Medicaid-enrolled children with and without chronic health conditions

Ambul Pediatr 1:217-224. Department of Health Policy and Management, School of Hygiene and Public Health, Johns Hopkins University, Baltimore, MD, USA OBJECTIVE: Several capitation payment […]

Retrospective application of Adjusted Clinical Groups (ACGs) at a primary care centre

Aten Primaria 37:439-445. Published in Spanish. Dirección de Planificación, Badalona Servicios Asistenciales S.A. Badalona, Barcelona, España OBJECTIVE: To evaluate retrospectively the application of adjusted clinical […]

Using health-related quality of life assessments to evaluate care support within Medicaid

Care Manag J 9:42-50. Center for Health Research, Kaiser Permanente, Portland, OR, USA CareOregon, an Oregon-based not-for-profit Medicaid health plan, successfully piloted a “CareSupport” model […]

Prescription drug coverage, health, and medication acquisition among seniors with one or more chronic conditions

Med Care 42:1056-1065. http://www.ncbi.nlm.nih.gov/pubmed/15586832. Department of Sociology, University of Washington, Seattle, WA, USA. BACKGROUND: The unabated rise in medication costs particularly affects older persons with […]

Primary care utilisation patterns among an urban immigrant population in the Spanish National Health System.

BMC Public Health 11:432. Instituto Aragonés de Ciencias de la Salud, Instituto de Investigación Sanitaria Aragón, Zaragoza, Spain BACKGROUND: There is evidence suggesting that the […]

A population-based study of periodontal care among those with and without diabetes

J Periodontol 82:1650-1656. Group Health Research Institute, Seattle, WA, USA BACKGROUND: Our objectives were to describe the prevalence of periodontal care (a marker of periodontitis) […]

The effect of complementary and alternative medicine claims on risk adjustment

Med Care 44:1078-1084. Department of Nursing, Boise State University, Boise, ID, USA OBJECTIVE: We sought to assess how the inclusion of claims from complementary and […]

Assessment of pharmacological strategies for management of major depressive disorder and their costs after an inadequate response to first-line antidepressant treatment in primary care

Ann Gen Psychiatry 11:22. AstraZeneca Medical Department, Madrid, Spain BACKGROUND: The aim of the study was to determine the most common treatment strategies and their […]

More data in health care will enable predictive modeling advances

Manag Care 22:39-41. Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA No abstract PMID: 23451538

Is patient satisfaction in primary care dependent on structural and organizational characteristics among providers? Findings based on data from the national patient survey in Sweden

Health Econ Policy Law 8:317-333. Lund University School of Economics and Management, Lund, Sweden In parallel to market-like reforms in Swedish primary care, the gathering […]

Association between metformin use and risk of prostate cancer and its grade 

J Natl Cancer Inst 105:1123-1131. Division of Urology, Department of Surgical Oncology, Princess Margaret Hospital, University Health Network, Toronto, ON, Canada BACKGROUND: Metformin is commonly […]

Inclusion of persons with mental illness in patient-centred medical homes: cross-sectional findings from Ontario, Canada

Open Med 7:e9-e20. Department of Family and Community Medicine, University of Toronto, Toronto, ON, Canada BACKGROUND: In Ontario, Canada, the patient-centred medical home is a […]

Comparative operative outcomes of early and delayed cholecystectomy for acute cholecystitis: a population-based propensity score analysis

Ann Surg 259:10-15. Sunnybrook Research Institute, Sunnybrook Health Sciences Center; Li Ka Shing Knowledge Institute, St Michael’s Hospital; and ‡Institute for Clinical Evaluative Sciences, Toronto, […]

Effects of dementia on postoperative outcomes of older adults with hip fractures: a population-based study

J Am Med Dir Assoc. Queen’s University, Kingston, ON, Canada; Institute for Clinical Evaluative Sciences, Queen’s University, Kingston, ON, Canada; Women’s College Hospital, Toronto, ON, […]

Adverse cardiac events in older patients receiving venlafaxine: a population-based study

J Clin Psychiatry 75:e552-e558. Sunnybrook Health Sciences Centre, Toronto, ON, Canada OBJECTIVE: Venlafaxine is a commonly prescribed antidepressant, but whether its noradrenergic effects impart increased […]

Federal disaster declarations and denials: analyzing spatial equity in the implementation of the Stafford Act

Tampa, FL, USA: University of South Florida (doctoral dissertation). University of South Florida, Tampa, FL, USA Federal disaster declarations are authorized by the president under […]

VG primarvard i for hallande till riksrevisionens rapport “primaryvardens styrning – efter behov eller efterfragan?”

Vanersborg, Sweden: Vastra Gotalandsregionen. Published in Swedish. Vastra Gotalandsregionen, Vanersborg, Sweden

Evaluation of the Maryland Multi-Payor Patient Centered Medical Home Program

Final report. Columbia, MD: IMPAQ International. IMPAQ International, Columbia, MD, USA; Johns Hopkins University, Baltimore, MD, USA; University of Maryland, Baltimore, MD, USA The Maryland […]

Hold it – my patients are sicker! The importance of case mix adjustment to practitioner profiles in British Columbia

British Columbia Med J 43:328-333. Ministry of Health and Ministry Responsible for Seniors, Province of British Columbia; UBC Centre for Health Services & Policy Research, […]

Optimal pricing of employment-based health plans

Minneapolis, MN, USA: University of Minnesota (doctoral dissertation). University of Minnesota, Minneapolis, MN, USA Employer-provided health insurance is a major component of the health care […]

Selection of Medicaid beneficiaries for chronic care management programs: overview and uses of predictive modeling

Shrewsbury, MA: Center for Health Policy and Research. Center for Health Policy and Research, University of Massachusetts Medical School, Shrewsbury, MA, USA Effective use of […]

ACGs: an ambulatory care case-mix measure. Health Quality section update

Center for Health Quality Outcomes and Economic Research. Bedford, MA, USA: CHQOER Quarterly, ENRM VA Hospital. Center for Health Quality Outcomes and Economic Research, Bedford, […]

Morbidity, service utilization and health spending in Montrealers aged 65 and older in 2005-2006: an application of the Johns Hopkins “Adjusted Clinical Group” system

Montreal, QC, Canada: Montreal Health and Social Services Agency. Published in French; also have English translation. Montreal Health and Social Services Agency, Montreal, QC, Canada […]

Risk adjustment and Medicare

New York, NY, USA: Commonwealth Fund. Division of Health Policy Research and Education, Harvard University, Boston, MA, USA Almost all observers agree in principle that […]

Implementing a model for risk distribution among competing health plans

Final report. Princeton, NJ, USA: Robert Wood Johnson Foundation.

Health-based capitation risk adjustment in Minnesota public health care programs

Health Care Financ Rev 26:21-41. Gregory A. Gifford and Kevan R. Edwards are with the Minnesota Department of Health. David J. Knutson is with the […]

Facilitating equity and efficiency in Malaysian primary health care through the application of the ACG® case mix system

BMC Health Serv Res 9(Suppl 1):A7. Ministry of Health, Malaysia     Introduction: Malaysian health care is a parallel system with both public and private sectors. […]

Socioeconomic status and the use of medicines in the Ontario Public Drug Program

Canadian Public Policy 37:563-576. University of Toronto, Toronto, ON, Canada Residents of Ontario aged 65 years and older are covered by a provincially funded prescription […]

El analisis de la morbilidad y comorbilidad como instrumento para facilitar la gestion clinical y organizacion de los servicios en atencion primaria

SEMG 139:441-448. Published in Spanish. Gerencia de Atencion Primaria del Area de Salud de Tenerife, Spain No abstract

Coût de l’ordonnance des médecins généralistes: une analyse sur les données de l’EPPM

Economie Publique :239-269. Published in French. Ministère des Affaires sociales et de la Santé, Paris, France Cet article examine de manière critique la possibilité de  […]

The 2013 RHA indicators atlas

Winnipeg, MB, Canada: Manitoba Centre for Health Policy. Manitoba Centre for Health Policy, Winnipeg, MB, Canada The results in this report show clearly that the […]

Paying for primary care: the factors associated with physician self-selection into payment models

Working paper no. 2014-06. Toronto, ON, Canada: Canadian Centre for Health Economics. Canadian Centre for Health Economics, Toronto, ON, Canada In this paper we use […]

Introduction and Applications of the ACG System on Veteran in Taiwan

Taipei Veterans General Hospital Introduction and Applications of the ACG System on Veteran Population in Taiwan Dr. Wui-Chiang Lee, MD, PhD. CEO, Taiwan Joint Commission on […]

Tuesday-Utilization-Freund

University Hospital Heidelberg Modelling care sensitivity using ACG® systems – Insights from a German cohort study Tobias Freund, MD.

Monday-Keynote II-Kinder

Johns Hopkins ACG System Looking Back, Looking Forward: Celebrating the ACG System’s 20 Year Role in Improving Health Care Karen Kinder Jonathan Weiner

Benefits for South Central

NHS – South Central Primary Care Trust Alliance Benefits from the ACG System in South Central Alan Thompson, Programme Manager

A comprehensive care management programme focused on emerging and high risk individuals

Medscheme High and Emerging Risk Population Management London Symposium on Case Mix Risk Stratification to Support Integrated Care

Tuesday(C7)-Use of ACG System for Health Plan Collaboration with Primary Care Practices to Reduce Inpatient Admissions —Melissa Sherry

Use of ACG System for Health Plan Collaboration with Primary Care Practices to Reduce Inpatient Admissions  —Melissa Sherry

Monday(C5)-Application of ACGs in an Israeli Health care System-Primary Care Utilization Bands-Shadmi

Application of ACGs in an Israeli Health care System: Primary Care Utilization Bands Local calibration of ACGs to account  for the burden primary care physicians […]

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Leveraging Care Density: A New Way to Measure and Enhance Care Coordination

If optimizing quality of care, clinical outcomes and cost effectiveness is one of your priorities, ensuring your patient population receives comprehensive, coordinated care from their […]

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Video: ACG System Overview

Interested in learning more?View the ACG System Overview    

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 […]