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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, […]

Capitation payment systems – risk factor estimation

Academia Economic Papers 28:231-261. Published in Chinese. PURPOSE: To explore risk factors that can explain individual medical expenditure. SAMPLE: Subjects included in “1996 NHI Satisfaction […]

Managing the gap: evaluating the impact of Medicaid managed care on service use and disparities in health care access

Baltimore, MD, USA: University of Maryland (doctoral dissertation). University of Maryland, Baltimore, MD, USA The National Institutes of Health (NIH) define a health disparity as […]

Identifying patients with high pharmacy consumption by using the Adjusted Clinical Groups in a primary care setting

European Neuropsychopharmacology 19:S340-S341. Badalona Serveis Assistencials SA, Directorate ofPlanning, Badalona. Barcelona, Spain BACKGROUND: Prescription drug costs are rapidly increasing in most countries. The pharmaceutical expenditure […]

Plataforma de proces de dades d’atencio primaria

Barcelona, Spain: Universitat Politecnica de Catalunya (masters thesis). Published in Catalan. Universitat Politecnica de Catalunya, Spain No abstract

Measuring the casemix of physician practices in primary-care reform models in Ontario, Canada

BMC Health Serv Res 11:A22. Institute for Clinical Evaluative Sciences, Toronto, ON, Canada INTRODUCTION: A number of different blended-payment models for primary- care delivery have […]

Patients with chronic illness in the patient-centered medical home: costs, use, quality and morbidity-based variation

Seattle, WA, USA: University of Washington (doctoral dissertation). University of Washington, Seattle, WA, USA Originally described in 1967 as a central source of a medical […]

Evaluation of the full service family practice incentive program and the practice support program: synthesis report for work completed to June 2013

Victoria, BC, Canada: Hollander Analytical Services Ltd. This report constitutes a synthesis of findings from the evaluation of the Full Service Family Practice Incentive Program […]

Kan casemix-systemer anvendes i den danske primaersektor?

Odense, Denmark: Syddansk Universitet. Published in Danish. Syddansk University, Odense, Denmark Dette arbejdspapir er udarbejdet af Forskningsenheden for Almen Praksis (FEA) og Center for Sundhedsøkonomisk […]

Population-based Study of the Effect of Free Influenza Vaccination on Medical Utilization of Elderly

National Yang Ming University A Population-based Study of the Effect of Free Influenza Vaccination on Medical Utilization of Elderly Taiwanese Ching Wen Chien, Ph.D.

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

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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.

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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.

Outcomes of patients with chronic obstructive pulmonary disease diagnosed with or without pulmonary function testing

Background: A small number of people with chronic obstructive pulmonary disease (COPD) receive pulmonary function testing around the time of diagnosis. Because omitting testing increases […]

Defining and Assessing Geriatric Risk Factors and Associated Health Care Utilization Among Older Adults Using Claims and Electronic Health Records

Abstract Background: Using electronic health records (EHRs), in addition to claims, to systematically identify patients with factors associated with adverse outcomes (geriatric risk) among older […]

A Canadian Population-Based Cohort to the Study Cost and Burden of Surgically Resected Hidradenitis Suppurativa

Abstract Background: Hidradenitis suppurativa (HS) is a chronic debilitating disease with long-lasting comorbidities that impose direct and indirect costs on the health care system. However, […]

Medicaid trends in prescription opioid and non-opioid use by HIV status

Abstract   Background Pain is more common among people living with HIV (PLWH) than their counterparts; however, it is unclear whether analgesic use differs by […]

Supporting general practice to make timely decisions for better health care: a population health approach

Abstract Primary Health Networks (PHNs) are tasked to enhance the efficiency and effectiveness of general practice. Gold Coast Primary Health Network (GCPHN) has been collecting […]

Is Post-discharge Rehabilitation Timing Associated with 90-Day Readmission in Primary Total Joint Arthroplasty?

Abstract Background Physical therapy (PT) is an accepted standard of care after total joint arthroplasty (TJA) and essential to maximizing joint functionality and minimizing complications […]

Prediction of 30-day pediatric unplanned hospitalizations using the Johns Hopkins Adjusted Clinical Groups risk adjustment system

Abstract Background The Johns Hopkins ACG System is widely used to predict patient healthcare service use and costs. Most applications have focused on adult populations. […]

Impact of comprehensive care on health care use among a cohort of marginalized people living with hepatitis C in Toronto, Canada

Abstract Background The majority of new hepatitis C (HCV) cases occur among people who inject drugs. In recent years, multidisciplinary models of HCV treatment have […]

Association of Follow-Up Care With Long-Term Death and Subsequent Hospitalization in Patients With Atrial Fibrillation Who Receive Emergency Care in the Province of Ontario

Abstract Background Currently, 11% of patients seen in the emergency department for atrial fibrillation die within 1 year of the visit. Our objective was to […]

Measuring multimorbidity beyond counting diseases: systematic review of community and population studies and guide to index choice

Abstract Objectives To identify and summarise existing indices for measuring multimorbidity beyond disease counts, to establish which indices include mental health comorbidities or outcomes, and […]

Health characteristics of reproductive-aged autistic women in Ontario: A population-based, cross-sectional study

Abstract While an increasing number of girls and women are being identified with autism, we know little about the health of reproductive-aged autistic women. Our […]

The effect of frailty on postoperative readmissions, morbidity, and mortality in endometrial Cancer surgery

Abstract Objectives To determine the impact of frailty on postoperative readmission, morbidity, and mortality among patients undergoing surgery for endometrial cancer. Methods Patients with endometrial […]

Association between mental health comorbidity and health outcomes in type 2 diabetes mellitus patients

Abstract Background Type 2 diabetes mellitus (T2D) is often accompanied by chronic diseases, including mental health problems. We aimed at studying mental health comorbidity prevalence […]

Analysis of modifiable and nonmodifiable risk factors in patients undergoing pituitary surgery

Abstract OBJECTIVE Pituitary adenomas (PAs) are among the most common intracranial tumors. Understanding the clinical effects of various modifiable risk factors (MRFs) and nonmodifiable risk […]

Health care service use and costs for a cohort of high-needs elderly diabetic patients

Abstract Aims To describe the impact of diabetes comorbidities on the health care services use and costs of a cohort of elderly patients with diabetes […]

Management and outcomes of patients with chronic obstructive lung disease and lung cancer in a public healthcare system

Abstract Hypothesis There is limited data on the care and outcomes of individuals with both chronic obstructive pulmonary disease (COPD) and lung cancer, particularly in […]

Guideline interval: A new time interval in the diagnostic pathway for symptomatic cancer

Abstract Background: A standard measure of the cancer diagnostic pathway, diagnostic interval, is the time from “first presentation of cancer” to diagnosis. Cancer presentation may be […]

Impact of Frailty on Clinical and Financial Outcomes Following Minor Lower Extremity Amputation: A Nationwide Analysis

Abstract Objective Frailty has been shown to portend worse outcomes in surgical patients. Our goal was to identify the impact of frailty on outcomes and […]

The clinical impact of frailty on the postoperative outcomes of patients undergoing gastrectomy for gastric cancer: a propensity-score matched database study

Abstract Background Frailty aggregates a composite of geriatric and elderly features that is classified into a singular syndrome; literature thus far has proven its influence […]

Outcomes of SARS-CoV-2 infection in cancer versus non-cancer-patients: A population-based study in northeastern Italy

Abstract Introduction This study assesses the risk of infection and clinical outcomes in a large consecutive population of cancer and non-cancer patients tested for SARS-CoV-2 […]

Survival effects of time to surgery for Stage I lung cancer: A population-based study

Abstract Objectives To examine the impact of time to surgery (TTS) on survival among patients with stage I non-small cell lung cancer (NSCLC). Methods All […]

Development and validation of predictive models for unplanned hospitalization in the Basque Country: analyzing the variability of non-deterministic algorithms

Abstract Background The progressive ageing in developed countries entails an increase in multimorbidity. Population-wide predictive models for adverse health outcomes are crucial to address these […]

Health Utilities in People with Hepatitis C Virus Infection: A Study Using Real-World Population-Level Data

Abstract Background Hepatitis C virus (HCV) infection is associated with reduced quality of life and health utility. It is unclear whether this is primarily due […]

Delay in Diabetes Diagnosis After High-Deductible Health Plan Enrollment: A Pre-Post Study with Control

Abstract Background High-deductible health plan (HDHP) members face relatively high out-of-pocket (OOP) costs for urgent care, high-acuity care, and secondary prevention. These costs could affect […]

Using Machine Learning To Predict Future Foster Care Admission

Structured Abstract Introduction Foster care admissions are highly traumatic for children and their families, often causing serious adverse outcomes. We seek to assess the viability […]

Impact of age and frailty on acute care use during immune checkpoint inhibitor treatment

Abstract Purpose Older and frail adults were under-represented in clinical trials evaluating ICIs, leading to a knowledge gap on their risk of acute care use […]

Disparities in End-of-Life Care: A Retrospective Study on Intensive Care Utilization and Advance Care Planning in the Colorado All-Payer Claims Database

Abstract Background Intensive end-of-life (EOL) care is emotionally and financially burdensome, disproportionally negatively impacting racial and ethnic minorities, rural residents, and lower socioeconomic seniors. Objectives […]

Design and early evaluation of a social care network’s impact on health care costs

Abstract Introduction The Social Care Network (SCN) is a payor–provider-system integrated social care referral model designed to address historical challenges of scalability and sustainability through […]

Lung Transplantation in Rheumatoid Arthritis Related Interstitial Lung Disease: Risk Factors and Mortality in a Universal Health Care System

ABSTRACT Background Despite therapy, some patients with rheumatoid arthritis related interstitial lung disease (RA-ILD) require lung transplantation for progressive disease. We aimed to identify factors […]

Primary care continuity and breast cancer survival: a retrospective cohort study

Abstract Purpose Primary care provider (PCP) continuity improves many health outcomes, but its impact on breast cancer survival remains unclear. We examined how baseline PCP […]

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 […]

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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 […]

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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 […]

Effect of attribution length on the use and cost of health care for a pediatric Medicaid Accountable Care Organization

JAMA Pediatr 170:148-154. Children’s Hospitals and Clinics of Minnesota, Minneapolis, MN, USA IMPORTANCE: Little is known about the effect of pediatric accountable care organizations (ACOs) […]

Factors associated with acute care use among nursing home residents dying of cancer: a population-based study

Int J Palliat Nurs 21:349-356. McMaster University, Hamilton, ON, Canada BACKGROUND: Little is known about residents of long-term care (LTC) facilities who die of cancer. […]

Predictors of opioid-related death during methadone therapy

J Subst Abuse Treat 57:30-35. University of Toronto, ON, Canada; Institute for Clinical Evaluative Sciences, Toronto, ON, Canada; St. Michael’s Hospital, Toronto, ON, Canada; St. […]

The potential for community-based health information exchange systems to reduce hospital readmissions

J Am Med Inform Assoc 22:435-442. Weill Cornell Medical College, New York, NY, USA BACKGROUND: Hospital readmissions are common, costly, and offer opportunities for utilization […]

Fifty years of pediatric asthma in developed countries: how reliable are the basic data sources?

Pediatr Pulmonol 47:211-219. British Columbia’s Children’s Hospital, Vancouver, BC, Canada Given the difficulties in diagnosing, or even defining, asthma in children, claims of a pediatric […]

Application of the Ambulatory Care Groups in the primary care of a European national health care system: does it work?

Med Care 37:238-248. Astrabudúa Health Center, Osakidetza/Basque Health Service, Bizkaia, Spain BACKGROUND: Ambulatory Care Groups (ACGs), a US case mix system that uses the patient […]

Quality assessment: is the focus on providers or on patients?

Int J Qual Health Care 8:231-241. Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, USA Most studies of ambulatory care quality are based on chart […]

Biphasic fracture risk in diabetes: a population-based study

Bone 40:1595-1601. Department of Medicine, University of Manitoba, Winnipeg, MB, Canada Diabetes is associated with increased fracture rates but the effect size, time course and […]

The comorbidity burden of the treated asthma patient population in British Columbia

Chronic Dis Can 30:46-55. University of British Columbia, Faculty of Pharmaceutical Sciences, Vancouver, BC, Canada To date there has been little investigation of the prevalence […]

Nonparticipation in a population-based trial to increase colorectal cancer screening

Am J Prev Med 42:390-397. Group Health Permanente, University of Washington Medical School, Seattle, WA, USA BACKGROUND: Many trials have tested different strategies to increase […]

Institutionalization following incident non-traumatic fractures in community-dwelling men and women

Osteoporos Int 23:2381-2386. Division of General Internal Medicine, McGill University Health Center, Montreal, QC, Canada Institutionalization after hip fracture occurs in at least 30% of […]

Methods for analyzing health care utilization and costs

Annu Rev Public Health 20:125-144. Department of Biostatistics, University of Washington, Seattle, WA, USA Important questions about health care are often addressed by studying health […]

Mortality rates after incident non-traumatic fractures in older men and women.

Osteoporos Int 22:2439-2448. Division of General Internal Medicine, McGill University Health Center, Montreal, QC, Canada Non-traumatic fractures at typical osteoporotic sites are associated with increased […]

Comorbidity patterns in patients with chronic diseases in general practice

PLoS One 7:e32141. Multiprofessional Education Unit for Family and Community Care (Southwest), Madrid, Spain INTRODUCTION: Healthcare management is oriented toward single diseases, yet multimorbidity is […]

Primary care physician compensation method in medical groups: does it influence the use and cost of health services for enrollees in managed care organizations?

JAMA 279:853-858. Department of Health Services, University of Washington, Seattle, WA, USA CONTEXT: Growth of at-risk managed care contracts between health plans and medical groups […]

Health-based payment and computerized patient record systems

Eff Clin Pract 1:66-72. Center for Health Research, Kaiser Permanente, Northwest Division, Portland, OR, USA. Health care information technology is changing rapidly and dramatically. A […]

Morbidity and older persons’ perceptions of the quality of their primary care

J Am Geriatr Soc 54:330-334. Department of Health Policy and Management, Bloomberg School of Public Health, School of Medicine, Johns Hopkins University, Baltimore, MD, USA […]

Primary care physicians’ experiences with case finding for practice-based care management

Am J Manag Care 18:e155-161. Department of General Practice and Health Services Research, University Hospital Heidelberg, Heidelberg, Germany. OBJECTIVES: The identification of patients most likely […]

A population-based analysis of the clinical course of 10,304 patients with acute cholecystitis, discharged without cholecystectomy

J Trauma Acute Care Surg 74:26-30; discussion 30-1. Li Ka Shing Knowledge Institute, St Michael’s Hospital; and Institute for Clinical Evaluative Science, Toronto, ON, Canada […]

Self-referral in point-of-service health plans

JAMA 285:2223-2231. Department of Health Policy and Management, Johns Hopkins School of Hygiene and Public Health, Baltimore, MD, USA CONTEXT: Most health maintenance organizations offer […]

Cost and quality trends in direct contracting arrangements

Health Aff 21:89-102. Health Systems Management Faculty, School of Public Affairs, University of Baltimore, Baltimore, MD, USA. This paper presents the first empirical analysis of […]

Impact of open-access scheduling on realized access

Health Serv Manage Res 20:134-139. Department of Family Medicine, Mayo Clinic, Rochester, MN, USA Open-access or advanced-access scheduling, which opens the clinic calendar to patients […]

Influence of morbidity and the use of health resources in patients who require care for generalised anxiety disorder in the primary health care setting

Aten Primaria 40:603-610. Published in Spanish. Dirección de Planificación. Badalona Serveis Assistencials, S.A. Badalona. Barcelona, Spain OBJECTIVE: To evaluate the co-morbidity, health care use, economical […]