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The Johns Hopkins ACG® System Bibliography provides links to more than 900 papers and reports from across the globe detailing various studies utilizing the ACG System in a variety of locations, populations, and innovative applications.
Please use the below search box to find articles on specific topics or keywords. You can also use the filters below to refine further.
Abstract Purpose It is difficult to reduce cost and improve quality without knowledge pertaining to the distribution of expenses in the population in question. We […]
Abstract Background Twenty-five states have implemented insulin out-of-pocket (OOP) cost caps, but their effectiveness is uncertain. Objective To examine the effect of state insulin OOP […]
Abstract Introduction Increased attention has been given to multimorbidity. This phenomenon often has been explored through associations between diseases based on the frequency of combinations […]
Abstract Background: A growing number of US states are implementing programs to address the social needs (SNs) of their Medicaid populations through managed care contracts. […]
Abstract Decisions to adopt health technologies rely, in part, on judgements about cost effectiveness. Cost effectiveness is commonly assessed against a willingness-to-pay threshold for health […]
Abstract The rise in health care costs, caused by older and more complex patient populations, requires Population Health Management approaches including risk stratification. With risk […]
Abstract Aim Length of stay (LOS) after colorectal surgery (CRS) is a significant driver of healthcare utilization and adverse patient outcomes. To date, there is […]
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 […]
Abstract Objectives: This study examined how frailty in traditional risk-adjusted models could improve the predictability of unplanned 30-day readmission and mortality among heart failure patients. […]
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 […]
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. […]
Abstract Purpose Frailty instruments may improve prognostic estimates for patients undergoing transcatheter aortic valve implantation (TAVI). Few studies have evaluated and compared the performance of […]
Abstract Context Social determinants of health are an important predictor of future health care costs but little is known about their impact on Medicaid spending. […]
Abstract Objective Patient vital signs are related to specific health risks and outcomes but are underutilized in the prediction of health-care utilization and cost. To […]
Abstract Objectives Reconstructive surgery may result in prolonged postoperative recovery, especially in frail patients, which in turn may impact delivery of adjuvant therapy. To date, […]
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 […]
Abstract Patients enrolled in Medicaid have significantly higher social needs (SNs) than others. Using claims and electronic health records (EHRs) data, managed care organizations (MCOs) […]
Abstract Background Network analysis, a technique for describing relationships, can provide insights into patterns of co-occurring chronic health conditions. The effect that co-occurrence measurement has […]
Abstract Background Colombia’s health system allows workers to claim paid sick leave due to health conditions, some of this conditions are related to metabolic and […]
Abstract Objective Health care providers increasingly rely upon predictive algorithms when making important treatment decisions, however, evidence indicates that these tools can lead to inequitable […]
Abstract Background Three claims-based pharmacy markers (complex, costly and risky medications) were developed to help automatically identify patients for comprehensive medication management. Objective To evaluate […]
ABSTRACT Objectives To produce an efficient and practically implementable method, based on primary care data exclusively, to identify patients with complex care needs who have […]
ABSTRACT BACKGROUND Patient effort to comply with complex medication instructions is known to be related to nonadherence and subsequent medical complications or health care costs. […]
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 […]
Abstract Background Children and youth with intellectual and developmental disabilities (IDD) experience health disparities. What is unknown is if data collected from children and youth […]
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 […]
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 […]
Abstract Health and well-being are promoted when primary care teams partner with patients and provide care coordination to mitigate risks and promote optimal health. Identification […]
ABSTRACT Objective High-deductible health plans paired with health savings accounts (HSA-HDHPs) require substantial out-of-pocket spending for most services, including medications. We examined effects of HSA-HDHPs […]
Abstract SARS-CoV-2 variants of concern (VOC) are more transmissible and may have the potential for increased disease severity and decreased vaccine effectiveness. We estimated the […]
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 […]
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 […]
Abstract Background Patients in geriatric care display a high degree of multimorbidity. We aimed to explore and visualise various patterns of multimorbidity in a person-oriented […]
Abstract Objective To investigate coronavirus disease 2019 (COVID-19) hospitalization risk in patients with immune-mediated inflammatory diseases (IMIDs) compared with matched non-IMID comparators from the general […]
Abstract Technological advances embedded within algorithmic decision systems are being deployed every day. Some of these investments are unquestionably worthwhile, while some others prioritize commercialization […]
Abstract During recent years, multimorbidity has taken relevance because of the impact of causes in the system, people, and their families, which has been a […]
Abstract A high-deductible coverage is shown to reduce inappropriate health care, while little is known about its effect on social welfare under a reimbursement limit. […]
Abstract Background Multimorbidity measures are useful for resource planning, patient selection and prioritization, and factor adjustment in clinical practice, research, and benchmarking. We aimed to […]
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. […]
Abstract Objective To determine the association between directly measured physical activity and hospitalisation, intensive care unit (ICU) admission, ventilation and mortality rates in patients with […]
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 […]
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 […]
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 […]
Abstract Background People with intellectual/developmental disabilities (IDD) are reportedly intensive users of forensic inpatient services. Methods Using administrative data, we identified people with and without […]
Abstract Background Healthcare systems have increasingly adopted integrated care models with demonstrated effectiveness. However, few studies examine integrated care for individuals with co-morbid mental illness […]
Abstract Importance Individuals with cancer often have an elevated platelet count at the time of diagnosis. The extent to which an elevated platelet count is […]
Abstract Objective To examine the effect of frailty on short-term post-operative outcomes and total hospital charges (THCs) in patients with non-metastatic renal cell carcinoma, treated […]
Abstract Objective Health systems face multimorbidity as the leading cause of the burden of disease and demand for healthcare services. Although non-communicable diseases are well […]
Abstract Objective Practice guidelines advocating for regionalization of endometrial cancer surgery to gynecologic oncologists practicing in designated gynecologic oncology centres were published in Ontario in […]
Abstract Objectives To determine if bilateral salpingo-oophorectomy, compared with ovarian conservation, is associated with all cause or cause specific death in women undergoing hysterectomy for […]
Abstract Objective To evaluate the effectiveness of remote proactive management of toxicities during chemotherapy for early stage breast cancer. Design Pragmatic, cluster randomised trial. Setting […]
Abstract Background Early hospital readmissions (EHRs) occur commonly in kidney transplant recipients. Conflicting evidence exists regarding risk factors and outcomes of EHRs. Objective To determine […]
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; […]
Abstract Background Canadians are known to be frequent users of emergency department (ED) care. However, the exchange of information from ED visits to family physicians […]
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 […]
Abstract Background Wait times to chemotherapy are associated with morbidity and mortality in breast cancer patients; however, it is unclear how primary care physician (PCP) continuity […]
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 […]
Abstract Importance Opioids can impair motor skills and may affect the ability to drive; however, the association of opioid use with driving ability is not […]
Abstract Background A high proportion of health care services are persistently utilized by a small subpopulation of patients. To improve clinical outcomes while reducing costs […]
Abstract Background COPD medications reduce exacerbations and improve quality of life. Despite this, some individuals do not receive medications recommended by practice guidelines. Research Question […]
Abstract Objective To describe the proportion and identify predictors of community-dwelling individuals with traumatic spinal cord injury (TSCI) who were dispensed ≥1 publicly funded opioid […]
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 […]
Abstract Background It is well established that cancer patients infected with SARSCoV-2 are at particularly elevated risk of adverse outcomes, but the comparison of SARS-CoV-2 […]
Abstract Background In Canada, epidermal growth factor receptor (EGFR) inhibitor therapies in advanced non-small cell lung cancer (NSCLC) were initially approved regardless of EGFR status. The purpose […]
Abstract Objective To compare 4-year health care expenditures after RYGB vs sleeve gastrectomy, identify factors independently associated with 4-year health care expenditures, and compare the […]
Abstract Objective There has been growing interest in the potential role for allopurinol to reduce cardiovascular events in people with diabetes. While adherence to allopurinol is poor […]
Abstract Objectives To compare the risk of bladder cancer and bladder cancer mortality among patients with chronic bladder catheterisation (indwelling or intermittent) to patients from […]
Abstract The prevalence of Type 1 Diabetes (T1D) in the Veneto Region (Italy) in the 2015–2020 years was 152.5/100,000 subjects and the incidence 19.7/100,000 person-years. Accordingly, Veneto Region […]
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 […]
Abstract Purpose This study aimed to assess the impact of the patient-centered prescription (PCP) model in medication adherence and effective prescribing in patients with multimorbidity. […]
Abstract Aims To examine the real-world safety of adding bevacizumab to first-line irinotecan-based chemotherapy for patients with metastatic colorectal cancer (mCRC). Materials and methods Patients diagnosed with CRC in […]
Abstract Background High-intensity cancer surgery is increasingly common among older adults. However, these patients are at high-risk for unexpected intensive care unit (ICU) admissions after […]
Abstract Purpose This study evaluates the influence of patient frailty status on postoperative complications in those receiving single-level lumbar fusion surgery. Methods The nationwide readmission […]
Abstract Objective Most risk stratification approaches attempt to predict clinical outcomes rather than value. For a provider organization or health system to have financial success […]
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 […]
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 […]
Abstract Background The retirement of a family physician can represent a challenge in accessibility and continuity of care for patients. In this population-based, longitudinal cohort […]
Abstract Objective High deductible health plans (HDHPs) were introduced as a mechanism to reduce healthcare spending by incentivizing patients to be more cost-conscious while making […]
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 […]
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 […]
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 […]
Abstract Objective Multi-morbidity contributes to mortality and hospitalisation in COPD, but it is uncertain how this interacts with disease severity in risk prediction. We compared […]
Abstract Background Multiple sclerosis (MS) has been associated with certain comorbidities in general population studies, but it is unknown how comorbidity may affect immigrants with […]
Abstract Background Severe nutritional complications can occur following Roux-en-Y gastric bypass (RYGB). Adherence to follow-up visits can reduce the risk of many bariatric surgery complications, […]
Abstract Objective There has been an increase in surgical interventions in frailer elderly with concomitant chronic diseases. The purpose of this paper was to evaluate […]
ABSTRACT Background No research has assessed the individual-level impact of smoking cessation treatment delivered within a general primary care patient population on multiple forms of […]
Abstract Background Stigma and high-care needs can present barriers to the provision of high-quality primary care for people with opioid use disorder (OUD) and those […]
Abstract Objective This study examined the relationship between dysphagia and adverse outcomes across frailty conditions among surgical patients ≥50 years of age. Methods A retrospective cohort […]
Abstract Objective Previous research had shown the number of comorbidities is a major factor influencing the burden of care for elderly patients with obstructive lung […]
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. […]
ABSTRACT Background Optimizing the public health response to reduce the burden of COVID-19 necessitates characterizing population-level heterogeneity of risks for the disease. However, heterogeneity in […]
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 […]
Abstract Importance High-deductible health plans (HDHPs) are increasingly common and associated with decreased medication use in some adult populations. How children are affected is less […]
Abstract Importance Women physicians may delay childbearing and experience childlessness more often than nonphysicians, but existing knowledge is based largely on self-reported survey data. Objective […]
ABSTRACT Objectives There are multiple instruments for measuring multimorbidity. The main objective of this systematic review was to provide a list of instruments that are […]
Abstract Background To compare the effect of robot-assisted (RAPN) vs. open (OPN) partial nephrectomy on short-term postoperative outcomes and total hospital charges in frail patients […]
Abstract Importance Psychiatric emergency department (ED) visits may be avoidable if individuals have access to adequate outpatient care, but the extent to which individuals use […]
Abstract Objectives This study aimed to identify a threshold in annual surgeon volume associated with increased risk of revision (for any cause) and deep infection […]
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 […]
Abstract Purpose Our purpose was to contrast mortality associated with clinically undiagnosed prevalent vertebral fracture recognized on densitometric vertebral fracture assessment (VFA) and prior clinically […]
