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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. […]

Assessing the Impact of Body Mass Index Information on the Performance of Risk Adjustment Models in Predicting Health Care Costs and Utilization.

Abstract BACKGROUND: Using electronic health records (EHRs) for population risk stratification has gained attention in recent years. Compared with insurance claims, EHRs offer novel data […]

Supporting Commissioning Activities

The first part of this webinar will provide an introduction to the ACG System, the logic used within the software to determine morbidity patterns and […]

Using the ACG System to support population health management in Baltimore city

Presented by: Melissa Sherry, MPH, CPH

Director, Population Health Innovation and Transformation, Johns Hopkins HealthCare

This webinar presents a case study of the use of the ACG System to address the needs of a high risk, low income population in Baltimore City.

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

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

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

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

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

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

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

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

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

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

Children’s health care use in the Healthy Kids Program

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

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

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

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

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

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

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

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

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

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

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

Risk adjustment alternatives in paying for behavioral health care under Medicaid

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

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

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

The duration of ambulatory visits to physicians

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

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

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

Health information services technologies

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

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

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

Case selection for a Medicaid chronic care management program

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

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

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

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

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

Pay for performance: an excellent idea that simply needs implementation

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

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

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

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

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

Cholecystostomy: a bridge to hospital discharge but not delayed cholecystectomy

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

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

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

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

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

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

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

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

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

The contribution of longitudinal comorbidity measurements to survival analysis

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

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

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

Selection bias explains apparent differential mortality between dialysis modalities

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

Measuring data reliability for preventive services in electronic medical records

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

Influence of chronic co-morbidity on health costs

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Chapter 4: Effects of multimorbidity on healthcare resource use

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

Using case finding and risk stratification: a key service component for personalised care and support planning

London, UK: National Health Service. National Health Service. London, UK This handbook describes current thinking and provides practitioner insights into case finding and risk stratification […]

Population profiling in Slough CCG

Windsor, UK: NHS Slough Clinical Commissioning Group. NHS Slough Clinical Commissioning Group, Windsor, UK As our population ages and the prevalence of long term conditions […]

Editorial: Managing costs with software. Advance for Health Information Executives

Advance Newsmagazines, King of Prussia, PA, USA More than two years ago when Dave Ford took over as CEO at CareOregon in Portland, Ore., the […]

Validation and uses of the ACG-DX predictive modeling and risk adjustment tool in an Israeli HMO

Clin Med Res 8:51-52. Maccabi Healthcare Services, Tel Aviv, Israel BACKGROUND: With an ever increasing population of HMO members with chronic disease and continuing economic […]

The additional cost of chronic disease in Manitoba

Winnipeg, MB, Canada: Manitoba Centre for Health Policy. Manitoba Centre for Health Policy, University of Manitoba, Winnipeg, MB, Canada Many Manitobans have a chronic disease—indeed […]

A comparative analysis of methods of health risk assessment: final report

Cambridge, MA, USA: Harvard University School of Public Health. Harvard University School of Public Health, Cambridge, MA, USA A key component of many recent proposals […]

Implementing risk assessment and risk adjustment for people with disabilities in state programs: six case studies

Washington, DC, USA: NRH Center for Health and Disability Research. NRH Center for Health & Disability Research, Washington, DC, USA As a group, people with […]

A comparative analysis of claims-based tools for health risk assessment

Schaumburg, IL, USA: Society of Actuaries. Japanese translation published by Tokyo Gakugei University. Society of Actuaries, Schaumburg, IL, USA This Society of Actuaries research project […]

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

Readmissions: What Health Plans Need to Know

Preventing avoidable hospital readmissions is considered by many to be the most important opportunity for reducing waste in health care. This podcast explains readmissions and why identifying these at-risk patients is important to health plans. Learn more.

Case Mix Adjustment Case Study – Payer

This Case Study shows how Leicester City CCG, one of the most ethnically diverse areas of the UK, analyzed emergency admission rates for all practices, to learn that practices with lower emergency admission rates had significantly higher coding completeness and GP patient survey scores. Learn more.

Rehabilitation of Older Adults with Dementia After Hip Fracture

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

Risk of rhabdomyolysis from 5‐α reductase inhibitors

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

Respiratory health service utilization of children with neuromuscular disease

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Case Management and Care Coordination Part 1

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

Case Mix Adjustment in Primary Care

Presented by: Dr. David Shepherd FRCGP

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

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