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Documents

Development of a claims-based risk score to identify obese individuals

Popul Health Manag 13:201-207. Division of General Internal Medicine, Department of Medicine, Johns Hopkins University, Baltimore, MD, USA Obesity is underdiagnosed, hampering system-based health promotion […]

Comparison of health care expenditures among insured users and nonusers of complementary and alternative medicine in Washington State: a cost minimization analysis

J Altern Complement Med 16:411-417. Department of Health Services, University of Washington, Seattle, WA, USA OBJECTIVES: The purpose of this analysis was to compare health […]

Guided care: cost and utilization outcomes in a pilot study

Dis Manag 11:29-36. Johns Hopkins HealthCare, Glen Burnie, MD, USA Guided Care (GC) is an enhancement to primary care that incorporates the operative principles of […]

Identifying frail older people using predictive modeling

Am J Manag Care 18:e392-e397. Department of Geriatric Medicine, Maccabi Healthcare Services, Tel Aviv, Israel OBJECTIVES: To determine whether a designation of frailty using the […]

A randomized study to decrease the use of potentially inappropriate medications among community-dwelling older adults in a southeastern managed care organization

Am J Manag Care 10:761-768. Department of Medicine and Center for Healthcare Improvement, Medical College of Georgia, Atlanta, Ga, USA BACKGROUND: Despite progress in describing […]

Development and validation of a model for predicting inpatient hospitalization

Med Care 50:131-139. Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health and School of Medicine, Baltimore, MD, USA BACKGROUND: Hospitalizations […]

Involuntary unemployment and mortality in Taiwan

J Formos Med Assoc 103:900-907. Institute of Public Health, National Yang-Ming University, Taipei, Taiwan. BACKGROUND AND PURPOSE: Unemployment is known to be associated with increased […]

Case-control study of antibiotic use and subsequent Clostridium difficile-associated diarrhea in hospitalized patients

Infect Control Hosp Epidemiol 29:44-50. Permanente Medical Group, Oakland, CA, USA OBJECTIVE: To determine which antibiotics increase or decrease the risk of Clostridium difficile-associated diarrhea […]

More preventive care, and fewer emergency room visits and prescription drugs–health care utilization in a consumer-driven health plan

Benefits Q 24:46-54. Healthcare Informatics, Blue Cross Blue Shield of Minnesota, USA. Although consumer-driven health plans (CDHPs) have grown dramatically, the question of whether CDHPs […]

Assessing comorbidity using claims data: an overview

Med Care 40:IV-26-IV-35. Health Services and Economics Branch, Applied Research Program, Division of Cancer Control and Population Sciences, National Cancer Institute, Bethesda, MD, USA Comorbidity, […]

Pharmacy- and diagnosis-based risk adjustment for children with Medicaid

Med Care 43:1155-1159. Center for Child and Adolescent Health Policy, MassGeneral Hospital for Children, Department of Pediatrics, Harvard Medical School, Boston, MA, USA BACKGROUND: Risk […]

The influence of incidental abdominal aortic aneurysm monitoring on patient outcomes

J Vasc Surg 54:1290-1297.e2. Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada BACKGROUND: Incidental abdominal aortic aneurysms (AAAs) are identified when the abdomen is […]

Population based study of long-term rates of surgery for urinary incontinence after radical prostatectomy for prostate cancer

J Urol 188:502-506. Division of Urology, Sunnybrook Health Sciences Centre, Sunnybrook Research Institute, Toronto, ON, Canada PURPOSE: Urinary incontinence can be a significant complication of […]

Prescribing of psychotropic medications to the elderly population of a Canadian province: a retrospective study using administrative databases

PeerJ 1:e168. Faculty of Pharmacy, University of Manitoba , Winnipeg, MB, Canada BACKGROUND. Psychotropic medications, in particular second-generation antipsychotics (SGAs) and benzodiazepines, have been associated […]

Comparative safety and effectiveness of sitagliptin in patients with type 2 diabetes: retrospective population based cohort study

BMJ 346:f2267. Department of Public Health Sciences, School of Public Health, University of Alberta, Edmonton, AB, Canada OBJECTIVE: To determine if the use of sitagliptin […]

Association between fee-for-service expenditures and morbidity burden in primary care

Eur J Health Econ 15:599-610. Faculty of Health Sciences, COHERE-Centre of Health Economics Research, Institute of Public Health, University of Southern Denmark, Odense, Denmark BACKGROUND: […]

Using risk-adjustment models to identify high-cost risks

Med Care 41:1301-1312. Center for Health Research, Northwest and Hawaii, Kaiser Permanente Northwest, Portland, OR, USA BACKGROUND: We examine the ability of various publicly available […]

Predicting persistently high primary care use

Ann Fam Med 3:324-330. Division of Health Care Policy & Research, Department of Health Sciences Research, Mayo Clinic College of Medicine, Rochester, MN, USA PURPOSE: […]

Specialty use among patients with treated hypertension in a patient-centered medical home

J Gen Intern Med Division of General Internal Medicine and Geriatrics, Northwestern University, Feinberg School of Medicine, Chicago, IL, USA BACKGROUND: Little is known about […]

One-year outcomes associated with using observation services in triaging patients with nonspecific chest pain

Clin Cardiol 37:591-596. Division of Management, Policy and Community Health, University of Texas School of Public Health, Houston, Texas. BACKGROUND: Observation services are provided in […]

Changes in office visit use associated with electronic messaging and telephone encounters among patients with diabetes in the PCMH

Ann Fam Med 12:338-343. Group Health Research Institute, Seattle, WA, USA PURPOSE: Telephone- and Internet-based communication are increasingly common in primary care, yet there is […]

Measuring morbidity in populations: performance of the Johns Hopkins Adjusted Clinical Group (ACG) case-mix adjustment system in Manitoba

Winnipeg, MB, Canada: Manitoba Centre for Health Policy. Manitoba Centre for Health Policy, Winnipeg, MB, Canada This study examined the performance of the Johns Hopkins […]

Creating meaningful composite scores for primary care

2015 North American Primary Care Research Group Annual Meeting, October 2015, Cancun, Mexico. Context: Composite scores (CSs) provide a global measure of quality. CS development […]

Long-term risk of heart failure associated with adjuvant trastuzumab in breast cancer patients

2014 American Society of Clinical Oncology Annual Meeting. Abstract 9504. J Clin Oncol 32 (suppl; abstr 9504). University of Toronto, Toronto, ON, Canada; St. Michael’s […]

Is the class half empty? A population-based perspective on socioeconomic status and educational outcomes

IRPP Choices 12:1-30. Manitoba Centre for Health Policy, Department of Community Health Sciences, Faculty of Medicine University of Manitoba, Winnipeg, MB, Canada The purpose of […]

Characteristics of risk adjustment systems. Working Paper Series 2

Gainesville, FL, USA: Institute for Child Health Policy, University of Florida. Institute for Child Health Policy, University of Florida, Gainesville, FL, USA Increasing numbers of […]

Using the ACG case-mix adjustment system to evaluate veteran’s morbidity burdens and medical utilizations in Taiwan

J Healthc Manag 8:67-84. Published in Chinese. Department of Medical Affairs and Planning, Taipei Veterans General Hospital, Taipei City, Taiwan, ROC OBJECTIVES: Veterans have been […]

Performance of risk adjusted capitated systems in allocating a global budget

Baltimore, MD, USA: Johns Hopkins University (doctoral dissertation). Johns Hopkins University, Baltimore, MD, USA Rapidly rising health care costs in the United States have led […]

The Adjusted Clinical Groups (ACGs) system in Osakidetza

Final report (1/05/2003 – 30/04/2003). Vitoria-Gasteiz, Spain: Osakidetza Servicio vasco de salud. Published in Spanish. Osakidetza Servicio vasco de salud, Vitoria-Gasteiz, Spain No abstract

How are Manitoba’s children doing?

Winnipeg, MB, Canada: Manitoba Centre for Health Policy. Manitoba Centre for Health Policy, Winnipeg, MB, Canada The health and development of Manitoba’s children were examined […]

Using selected diagnoses to improve the Chilean capitation formula

Greifswald, Germany: Ernst Moritz Arndt University of Greifswald. Ernst Moritz Arndt University of Greifswald, Greifswald, Germany OBJECTIVES: To contribute to the policy discussion of equity […]

Home health services in British Columbia: a portrait of users and trends over time

Home health services in British Columbia: a portrait of users and trends over time. Vancouver, BC, Canada: University of British Columbia. University of British Columbia, […]

The effect of a coordinated care program on uninsured, chronically ill patients

Richmond, VA, USA: Virginia Commonwealth University (doctoral dissertation). Virginia Commonwealth University, Richmond, VA, USA This study explored how being enrolled in a program that both […]

Equity in the use and financing of medicines in British Columbia before and after the move to income-based pharmacare

Vancouver, BC, Canada: University of British Columbia (doctoral dissertation). University of British Columbia, Vancouver, BC, Canada BACKGROUND: In May 2003, the B.C. government introduced an […]

Utilizacion de servicios de salud en atencion primaria del area 11 de Madrid y nivel psicobioquimico de estres y de salud bucodental en su poblacion immigrante y autoctona

Madrid, Spain: Universidad Complutense de Madrid (masters thesis). Published in Spanish. Universidad Computense de Madrid, Madrid, Spain La naturaleza trashumante de la Humanidad le es […]

Developing decision trees to classify patients suited for similar interventions by combining clinical judgments with Leeds Risk Stratification Tool

London, UK: London School of Economics and Political Science. London School of Economics and Political Science, London, UK The objectives of the project are to […]

What is most important: social factors, health selection, and adolescent educational achievement

Soc Indic Res 110:385-414. Department of Community Health Sciences, Faculty of Medicine, Manitoba Centre for Health Policy, University of Manitoba, Winnipeg, MB, Canada This paper […]

Case Finding & Population Profiling – Separate Disciplines or Both Sides of the Same Coin?

This award-winning document presented at the 2015 PCSI conference highlights work undertaken with Slough Clinical Commissioning Group in the UK. The work has challenged some […]

Leicester City CCG Case Study 2

 Use of ACG® System output to support practices in participating in a medicines management scheme – STOPP-START

Care Management Program Case Study-Payer

Clalit Health (an integrated delivery system in Israel) used the ACG System to identify high-risk patients for enrollment in a comprehensive complex care management program […]

Case-Mix Information Uses and Health Services Sustainability

Iasist Casemix Information Uses and Health Services Sustainability: A Few Examples From Current Spanish Downturn Mercè Casas Carles Illa

Options for Concurrent Risk Assessment

DST Health Solutions Options for Concurrent Risk Assessment Amy Salls

Monday(C2)-Steep Increase of Registered Diagnosis Due to New Primary Care Funding Model-Martin Fredriksson

Steep Increase of Registered Diagnosis Due to New Primary Care Funding Model —Martin Fredriksson Region Västra Götaland Medical Advisor at Healtcare Department M.D. Ph.D.

Wednesday(P4)-Population Health Emerging Risk-Medscheme

Population Health Emerging Risk-Medscheme

PREDICTING HEALTHCARE COSTS IN VENETO REGION WITH ACG SYSTEM: VALIDATION AND COMPARISON OF DIAGNOSIS-BASED AND DRUG-BASED MORBIDITY GROUPS IN A NORTHERN ITALIAN POPULATION 

F. Avossa, 1, M.C. Corti, 2 , E. Schievano1, C. Abrams, 3 , N. Alba,  4 , S. Elvini, 5 , P. Gallina,  5, C. […]

Cost Risk Scores: Amy Salls, DST Health Solutions

ACG System The Johns Hopkins ACG® System Cost Risk Models Amy Salls

The ACG System and Public Health

Joshua Sharfstein, MD, Associate Dean of the Office of Public Health Practice & Training, Johns Hopkins Bloomberg School of Public Health and former Secretary of […]

Provider Profiling and Engagement Case Study – Payer

Johns Hopkins HealthCare (JHHC), the managed care arm of Johns Hopkins, created Provider Profile reports leveraging outputs from the Johns Hopkins ACG System to build a comprehensive Provider Engagement program.

Apples and Oranges: Four Definitions of Multiple Chronic Conditions and their Relationship to 30-Day Hospital Readmission

OBJECTIVES: To determine the extent of agreement between four commonly used definitions of multiple chronic conditions (MCCs) and compare each definition’s ability to predict 30-day […]

Are we making a difference in primary care for adults with intellectual and developmental disabilities?

Abstract Objectives. To examine the impact of the dissemination of guidelines to physicians and of a population-level health communication intervention on the percentage of adults […]

Supplement to “Equilibria in Health Exchanges: Adverse Selection versus Reclassification Risk”

This online appendix has three sections.  The first presents details of the choice model estimation algorithm, as well as additional estimates from our primary specification […]

Repeat Emergency Department Visits for Individuals With Intellectual and Developmental Disabilities and Psychiatric Disorders

Abstract Although individuals with intellectual and developmental disabilities (IDD) and psychiatric concerns are more likely than others to visit hospital emergency departments (EDs), the frequency […]

Integrating Social and Behavioral Determinants of Health into Population Health Analytics: A Conceptual Framework and Suggested Road Map

Abstract There is growing recognition that social and behavioral risk factors impact population health outcomes. Interventions that target these risk factors can improve health outcomes. […]

Frailty, Implantable Cardioverter Defibrillators, and Mortality: a Systematic Review

Abstract   Background Evidence for the benefit of implantable cardioverter defibrillators (ICD) in preventing sudden cardiac death (SCD) in older adults is mixed; age alone […]

Impact of care provider network characteristics on patient outcomes: Usage of social network analysis and a multi-scale community detection

Abstract Objective We assess healthcare provider collaboration and the impact on patient outcomes using social network analysis, a multi-scale community detection algorithm, and generalized estimating […]

MS risk in immigrants in the McDonald era: A population-based study in Ontario, Canada

Abstract OBJECTIVE To determine risk factors for multiple sclerosis (MS) in immigrants and to compare MS risk in immigrants and long-term residents in Ontario, Canada. […]

Preoperative frailty predicts adverse short‐term postoperative outcomes in patients treated with radical nephroureterectomy

Abstract Background To investigate the effect of frailty on short‐term postoperative outcomes and total hospital charges (THCs) in patients with non‐metastatic upper urinary tract carcinoma, […]

Who is discharged to intermediate care facilities? An Italian study in the population of Udine

ABSTRACT The objective of this study was to assess complexity of patients discharged from hospital to intermediate care facility in an Italian setting. Multiple anonymous […]

Alive and at home: Five-year outcomes in older adults following emergency general surgery

Abstract BACKGROUND While the short-term risks of emergency general surgery (EGS) admission among older adults have been studied, little is known about long-term functional outcomes […]

Shorter Diagnosis-to-Treatment Interval in Diffuse Large B-Cell Lymphoma is Associated With Inferior Overall Survival in a Large, Population-Based Registry

Abstract Background Because of prolonged screening requirements, patient and time-dependent selection have been proposed as potential biases in clinical trials. The screening process may exclude […]

Association of Preexisting Disability With Severe Maternal Morbidity or Mortality in Ontario, Canada

Abstract Objective To determine the risk of severe maternal morbidity or mortality among women with a physical, sensory, or intellectual/developmental disability compared with women without […]

Integrating E-Prescribing and Pharmacy Claims Data for Predictive Modeling: Comparing Costs and Utilization of Health Plan Members Who Fill Their Initial Medications with Those Who Do Not

Abstract BACKGROUND Nonfilling of prescribed medications is a worldwide problem of serious concern. Studies of health care costs and utilization associated with medication nonadherence frequently […]

Delay of Pregnancy Among Physicians vs Nonphysicians

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 […]

How different combinations of comorbidities affect healthcare use by elderly patients with obstructive lung disease

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 […]

Comparison of 4-Year Health Care Expenditures Associated With Roux-en-Y Gastric Bypass vs Sleeve Gastrectomy

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 […]

No Difference in Outcomes Between Short and Longer-Stay Total Joint Arthroplasty with a Discharge Home

Abstract Background: Outcomes following total hip arthroplasty (THA) and total knee arthroplasty (TKA) with a short length of hospital stay have been reported; however, most […]

Remote, proactive, telephone based management of toxicity in outpatients during adjuvant or neoadjuvant chemotherapy for early stage breast cancer: pragmatic, cluster randomised trial

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 […]

Case Study: The Distilling of a Biased Algorithmic Decision System through a Business Lens

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 […]

The Effect of Depression on Paid Sick Leave due to Metabolic and Cardiovascular Disease in low-wage workers. (Depression and Sick Leave)

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 […]

Changing patterns of multimorbidity among patients with ambiguous diagnoses: The case of Myalgic Encephalomyelitis/Chronic Fatigue Syndrome

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 […]

Readmissions Infographic

Preventing avoidable hospital readmissions is considered by many to be the most important opportunity for reducing waste in health care.  The Johns Hopkins ACG® System can […]

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 […]

Supporting Clinical Activities

The ACG System UK Team hosts a series of webinars aimed at providing an overview on a number of topics related to risk stratification, population […]

Predictive Modelling in Action

An introduction to the principles of predictive modeling in health care and examples of how predictive models are being used in the NHS in England. Learn more.

Do physicians who diagnose more mental health disorders generate lower health care costs?

J Fam Pract 49:305-310. University of Rochester School of Medicine, New York, NY, USA BACKGROUND: Underrecognition and undertreatment of mental health disorders in primary care […]

A cross-sectional, population-based study measuring comorbidity among people living with HIV in Ontario

BMC Public Health 14:161. Primary Health Care Research Centre, Bruyère Research Institute, Ottawa, ON, Canada BACKGROUND: As people diagnosed with HIV and receiving combination antiretroviral […]

Health information exchange and the frequency of repeat medical imaging

Am J Manag Care 20:eSP16-24. Weill Cornell Medical College, New York, NY, USA OBJECTIVES: Medical imaging, which is expensive, is frequently repeated for the same […]

Missed strokes using computed tomography imaging in patients with vertigo: population-based cohort study

Stroke 46:108-113. University of Toronto, Toronto, ON, Canada; University Health Network, Toronto, ON, Canada; Institute for Clinical Evaluative Sciences, Toronto, ON, Canada BACKGROUND AND PURPOSE: […]

The effect of pelvic fractures on future stress incontinence and pelvic organ prolapse surgery

Int Urogynecol J Western University, London, ON, Canad INTRODUCTION AND HYPOTHESIS: Pelvic fractures in women significantly disrupt the pelvic floor, which may cause stress urinary […]

Association between metformin use and mortality after cervical cancer in older women with diabetes

Cancer Epidemiol Biomarkers Prev 25:507-512. University Health Network, Toronto, ON, Canada; University of Toronto, Toronto, ON, Canada; Women’s College Hospital, Toronto, ON, Canada; Institute of […]

Effect of specialized diagnostic assessment units on the time to diagnosis in screen-detected breast cancer patients

Br J Cancer 112:1744-1750. Queen’s University, 10 Stuart Street, Kingston, ON, Canada; Cancer Care Ontario, Toronto, ON, Canada; Kingston General Hospital, Kingston, ON, Canada; University […]

Is the association between physical activity and healthcare utilization affected by self-rated health and socio-economic factors?

BMC Public Health 15:737. Lund University, Malmö, Sweden BACKGROUND: Physical activity and healthcare utilization has negative association. However, there appears to be limited knowledge of […]

Full-service family practice in British Columbia: policy interventions and trends in practice, 1991-2010

Healthc Policy 9:32-47. University of British Columbia Vancouver, BC, Canada BACKGROUND: British Columbia’s primary care reform (initiated in 2002) aims to promote “full-service family practice” […]

Risk-adjusted Medicare capitation rates using ambulatory and inpatient diagnoses

Health Care Financ Rev 17:77-99. Johns Hopkins School of Public Health, Baltimore, MD, USA Researchers at The Johns Hopkins University (JHU) developed two new diagnosis-oriented […]

Patient ability and willingness to participate in a web-based intervention to improve hypertension control.

J Med Internet Res 13:e1. Group Health Research Institute, Seattle, WA, USA BACKGROUND: Patient-shared electronic health records provide opportunities for care outside of office visits. […]

Measures of multimorbidity and morbidity burden for use in primary care and community settings: a systematic review and guide

Ann Fam Med 10:134-141. Academic Unit of Primary Health Care, School of Social and Community Medicine, Bristol University, Bristol, UK PURPOSE: Many patients consulting in […]

Development of a risk-adjusted capitation model based on principal inpatient diagnoses in Taiwan

J Formos Med Assoc 102:637-643. Graduate Institute of Health Policy and Management, College of Public Health, National Taiwan University, Taipei, Taiwan BACKGROUND AND PURPOSE: Taiwan’s […]

Use of proton pump inhibitors and risk of osteoporosis-related fractures

CMAJ 179:319-326. Department of Gastroenterology, Division of Internal Medicine, University of Manitoba, Winnipeg, MB, Canada BACKGROUND: The use of proton pump inhibitors has been associated […]

Formal risk adjustment by private employers

Inquiry 38:299-309. Department of Economics, Boston University, Boston, MA, USA This paper explores explanations for why few private employers have adopted formal risk adjustment. The […]

Patient use of secure electronic messaging within a shared medical record: a cross-sectional study

J Gen Intern Med 24:349-355. Group Health Cooperative, Center for Health Studies, Seattle, WA, USA BACKGROUND: Most patients would like to be able to exchange […]

HMO family physicians: men and women differ in their work

HMO Pract 9:155-161. Group Health Cooperative of Puget Sound, Seattle, WA, USA OBJECTIVE: The goal was to identify differences in the type of work and […]

Effect of premium, copayments, and health status on the choice of health plans

Med Care 46:1033-1040. Division of Health Care Policy & Research, Department of Health Sciences Research, Mayo Clinic, Rochester, MN, USA OBJECTIVE: Explore effects of comorbidity […]

Patient sharing among physicians and costs of care: a network analytic approach to care coordination using claims data

J Gen Intern Med 28:459-465. Johns Hopkins University School of Medicine, Baltimore, MD, USA BACKGROUND: Improving care coordination is a national priority and a key […]

Case-mix index and length of hospitalization

G Chir 31:211-214. Published in Italian. Department of Surgical Sciences, Sapienza University of Rome, Italy. The ACG (Adjusted Clinical Groups) case-mix system is a classification […]

ACG case-mix system aids contract assessment, improves performance

Data Strateg Benchmarks 4:21-26. The ABCs of ACGs. Adjusted clinical groups, or ACGs, a risk adjustment system developed by Baltimore-based Johns Hopkins University, are being […]

Realigning incentives in fee-for-service Medicare

Health Aff 22:59-70. Schneider Institute for Health Policy, Brandeis University, Waltham, MA, USA This paper proposes Medicare payment reform built on the fee-for-service system, with […]

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