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Documents

Association of surgical approach with oncologic outcomes in low-risk cervical cancer

Background Recent randomized evidence suggesting that simple hysterectomy is non-inferior to radical hysterectomy in cervical cancer patients with low-risk disease has invigorated questions about the […]

Improving Prediction of Risk of Admission to Long-Term Care or Mortality Among Home Care Users With IDD

ABSTRACT Background Frailty is an established predictor of admission into long-term care (LTC) and mortality in the elderly population. Assessment of frailty among adults with […]

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Identifying High-Risk Medicare Advantage Enrollees

Early identification of high-risk members provides the opportunity to manage the complex needs of this population. After one month in the plan, more than 50% […]

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Case Mix Adjustment in Practice

In this webinar, builds upon the introduction to the concept of case mix in the previous webinar and will share how case mix adjustment can […]

Improving the quality of outpatient care for older patients with diabetes: lessons from a comparison of rural and urban communities

J Fam Pract 50:676-680. University of Washington, Department of Family Medicine, Seattle, WA, USA OBJECTIVE: Our goal was to compare the quality of diabetic care […]

Why do physicians vary so widely in their referral rates?

J Gen Intern Med 15:163-168. Department of Family Medicine, University of Rochester, Rochester, NY, USA OBJECTIVE: To determine which physician practice and psychological factors contribute […]

Assessing population health care need using a claims-based ACG morbidity measure: a validation analysis in the province of Manitoba

Health Serv Res 37:1345-1364. Centre for Health Services and Policy Research, University of British Columbia, Vancouver, BC, Canada OBJECTIVES: To assess the ability of an […]

Health care costs, utilization and patterns of care following Lyme disease

PLoS One 10:e0116767. Johns Hopkins Bloomberg University, Baltimore, MD, USA BACKGROUND: Lyme disease is the most frequently reported vector borne infection in the United States. […]

Palliative care and the aggressiveness of end-of-life care in patients with advanced pancreatic cancer

J Natl Cancer Inst 107:p11: kju424. University Health Network, Toronto, ON, Canada; Institute of Medical Sciences, Toronto, ON, Canada BACKGROUND: We examined the impact of […]

Predicting costs of care using a pharmacy-based measure risk adjustment in a veteran population

Med Care 41:753-760. VA Puget Sound Health Care System, Seattle, WA, USA BACKGROUND: Although most widely used risk adjustment systems use diagnosis data to classify […]

Process of care for Medicaid-enrolled children with asthma: served by community health centers and other providers

Med Care 40:303-314. Institute for Health Care Research and Policy, Georgetown Public Policy Institute, Georgetown University, Washington, DC, USA OBJECTIVE: To compare the process of […]

A population-based study evaluating family physicians’ HIV experience and care of people living with HIV in Ontario

Ann Fam Med 13:436-445. Bruyère Research Institute, Ottawa, ON, Canada; University of Ottawa, Ottawa, ON, Canada; Ottawa Hospital Research Institute, Ottawa, ON, Canada; Institute for […]

Sex disparities in post-acute myocardial infarction pharmacologic treatment initiation and adherence: problem for young women

Circ Cardiovasc Qual Outcomes 8:586-592. University of British Columbia, Vancouver, BC, Canada BACKGROUND: The prevalence of the use of secondary prevention cardiovascular medications is lower […]

Increased surgeon experience with rheumatoid arthritis reduces the risk of complications following total joint arthroplasty

Arthritis Rheumatol 66:488-496. University of Toronto and Women’s College Hospital, Toronto, ON, Canada OBJECTIVE: To determine the relationship between surgeon experience with, and complications following, […]

Prevalence, expenditures, and complications of multiple chronic conditions in the elderly

Arch Intern Med 162:2269-2276. Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA BACKGROUND: The prevalence, health care […]

Ambulatory care groups: a categorization of diagnoses for research and management

Health Serv Res 26:53-74. Department of Health Policy and Management, Johns Hopkins School of Hygiene and Public Health, Baltimore, MD, USA This article describes a […]

Using the Johns Hopkins aggregated diagnosis groups (ADGs) to predict mortality in a general adult population cohort in Ontario, Canada

Med Care 49:932-939. Institute for Clinical Evaluative Sciences, Department of Health Management, Policy and Evaluation, University of Ottawa, Ottawa, ON, Canada BACKGROUND: Administrative healthcare databases […]

Preventable hospitalizations and socioeconomic status.

Health Aff 17:177-189. Wagner Graduate School, New York University, New York, NY, USA. “Preventable” hospitalizations have been proposed as indicators of poor health plan performance. […]

Applying diagnosis and pharmacy-based risk models to predict pharmacy use in Aragon, Spain: the impact of a local calibration

BMC Health Serv Res 10:22. Aragon Health Science Institute, Zaragoza, Spain BACKGROUND: In the financing of a national health system, where pharmaceutical spending is one […]

Ambulatory Care Groups and the profiling of primary care physician resource use: examining the application of case mix adjustments

J Ambul Care Manage 19:86-89. Center for Research in Ambulatory Health Care Administration, Englewood, CO, USA A variety of profiling models and tools is utilized […]

Ambulatory specialist use by nonhospitalized patients in us health plans: correlates and consequences

J Ambul Care Manage 32:216-225. Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA Approximately 7 of 10 (and 95% of the elderly) people […]

Impact of comorbidity on the individual’s choice of primary health care provider

Scand J Prim Health Care 29:104-109. Lund University, Department of Clinical Sciences in Malmö, General Practice/Family Medicine, Malmö, Sweden OBJECTIVE. This study examined whether age, […]

Comparing asthma care provided to Medicaid-enrolled children in a primary care case manager plan and a staff model HMO

Ambul Pediatr 3:253-262. Health Policy Institute, Georgetown University, Washington, DC, USA OBJECTIVE: To examine differences in selected processes of asthma care provided to Medicaid-enrolled children […]

Economic profiling of primary care physicians: consistency among risk-adjusted measures

Health Serv Res 39:985-1003. Health Management and Policy, University of Michigan, Ann Arbor, MI, USA OBJECTIVE: To investigate whether different risk-adjustment methodologies and economic profiling […]

Access intervention in an integrated, prepaid group practice: effects on primary care physician productivity

Health Serv Res 43:1888-1905. Department of Health Services, University of Washington, Seattle, WA, USA OBJECTIVE: To estimate the joint effect of a multifaceted access intervention […]

Risk classification of adult primary care patients by self-reported quality of life

Med Care 43:189-193. Department of Community and Family Medicine, Duke University Medical Center, Durham, NC, USA BACKGROUND: Although patient-reported health-related quality of life (HRQOL) is […]

Sleep complaints and their association with comorbidity and health-related quality of life in an older population in Sweden

Aging Ment Health 15:204-213. School of Health Science, Blekinge Institute of Technology, Karlskrona, Sweden OBJECTIVE: The relationship between sleep complaints, comorbidity and health-related quality of […]

Patients with atrial fibrillation and an alternative primary diagnosis in the emergency department: a description of their characteristics and outcomes

Acad Emerg Med 20:193-199. Institute for Clinical Evaluative Sciences, Toronto, ON, Canada OBJECTIVES: Atrial fibrillation is common in the emergency department (ED). Mortality rates at […]

Physical activity and influenza-coded outpatient visits, a population-based cohort study

PLoS One 7:e39518. Institute for Clinical Evaluative Sciences, Toronto, ON, Canada BACKGROUND: Although the benefits of physical activity in preventing chronic medical conditions are well […]

Risk adjustment of capitation payments to behavioral health care carve-outs: how well do existing methodologies account for psychiatric disability?

Health Care Manag Sci 3:159-169. Division of General Internal Medicine and Health Services Research, UCLA Department of Medicine, Los Angeles, CA, USA This study used […]

Pharmaceutical use among older adults: using administrative data to examine medication-related issues

Can J Aging 24 Suppl 1:81-95. Manitoba Centre for Health Policy, Department of Community Health Sciences, University of Manitoba, Winnipeg, MB, Canada Medication use is […]

The effects of complications and comorbidities on the quality of preventive diabetes care: a literature review

Popul Health Manag 11:217-218. Mathematica Policy Research, Washington, DC, USA Although concurrent conditions such as complications and comorbidities are common in people with diabetes, both […]

Cost of arterial hypertension according to levels of morbidity in primary care setting

Med Clin (Barc) 133:290-295. Published in Spanish. Dirección de Planificación, Badalona Serveis Assistencials SA, Badalona, Barcelona, España BACKGROUND AND OBJECTIVE: To determine the health care […]

Case study: the Minneapolis Buyers Health Care Action Group

Inquiry 35:171-177. Health Research Center, Institute for Research and Education, Health System Minnesota, Minneapolis, MN, USA Managed care plans are a type of health insurance. They […]

Physician and patient factors associated with follow up of high grade dysplasias of the cervix: a population-based study

Gynecol Oncol 120:63-67. Department of Obstetrics and Gynecology, Division of Gynecologic Oncology, University of Toronto, Toronto, ON, Canada OBJECTIVE: This population-based study characterizes available physician […]

Comparative ability of comorbidity classification methods for administrative data to predict outcomes in patients with chronic obstructive pulmonary disease

Ann Epidemiol 22:881-887. Institute for Clinical Evaluative Sciences, Toronto, ON, Canada PURPOSE: Administrative healthcare databases are used for health services research, comparative effectiveness studies, and […]

Review of methods used to measure comorbidity in cancer populations: no gold standard exists

J Clin Epidemiol 65:924-933. Cancer Control and Screening Research Group, Department of Public Health, University of Otago, Wellington South, New Zealand OBJECTIVE: This article reviews […]

Evaluating early repeat emergency department use in patients with atrial fibrillation: a population-based analysis

Am Heart J 165:939-948. Institute for Clinical Evaluative Sciences, Toronto, ON, Canada BACKGROUND: Emergency department (ED) use by patients with atrial fibrillation is high and […]

Primary care utilization and mental health diagnoses among adult patients requiring interpreters: a retrospective cohort study

J Gen Intern Med 28:386-391. Office of Women’s Health, Mayo Clinic, Rochester, MN, USA BACKGROUND: Patients requiring interpreters may utilize the health care system differently […]

Association between metformin therapy and mortality after breast cancer: a population-based study

Diabetes Care 36:3018-3026. Women’s College Research Institute, Women’s College Hospital, Toronto, ON, Canada OBJECTIVE: Metformin has been associated with a reduction in breast cancer risk […]

Obtaining the mean relative weights of the cost of care in Catalonia (Spain): retrospective application of the Adjusted Clinical Groups case-mix system in primary health care

J Eval Clin Pract 19:267-276. Directorate of Planning, Badalona Serveis Assistencials SA, Badalona, Spain OBJECTIVE: The study aims to obtain the mean relative weights (MRWs) […]

Exploratory analysis of high CT scan utilization in claims data

J Am Coll Radiol 11:51-58. University of Minnesota, Minneapolis, MN. USA; Arizona State University, Tempe, AZ, USA PURPOSE: This study explores characteristics that distinguish higher […]

Increased risk of complications following total joint arthroplasty in patients with rheumatoid arthritis

Arthritis Rheumatol 66:254-263. University of Toronto, Toronto, ON, Canada OBJECTIVE: Most of the evidence regarding complications following total hip arthroplasty (THA) and total knee arthroplasty […]

High-risk case identification for use in comprehensive complex care management

Popul Health Manag. Clalit Research Institute , Chief Physician’s Office, Clalit Health Services, Tel Aviv, Israel . The current study aimed to develop a patient […]

Association of the Hospital Volume of Frail Surgical Patients Cared for with Outcomes after Elective, Major Noncardiac Surgery

Background: Frailty is a risk factor for adverse postoperative outcomes. Hospitals that perform higher volumes of surgery have better outcomes than low-volume providers. We hypothesized […]

A health insurance plan with wellness features

Ithaca, NY, USA: Cornell University (doctoral dissertation). Cornell University, Ithaca, NY, USA Employers are increasingly using wellness programs to improve health and lifestyle of employees. […]

Medi-Cal and managed care: risk, costs, and regional variation

Sacramento, CA, USA: Public Policy Institute of California. Rollins School of Public Health, Emory University, Atlanta, GA; School of Public Health, University of Alabama at […]

Impact of center case volume on cardiotoxicity during adjuvant trastuzumab in breast cancer

2013 American Society of Clinical Oncology Annual Meeting. Abstract 6625. J Clin Oncol 31 (suppl; abstr 6625). University of Toronto, Toronto, ON, Canada; St. Michael’s […]

Mesurer la morbidite chez les patients diabetiques a Montreal.

Montreal, QC, Canada: Montreal Health and Social Services Agency. Published in French. Montreal Health and Social Services Agency, Montreal, QC, Canada No abstract

The actual versus expected health care use among Healthy Kids enrollees

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

Ambulatory case-mix methodologies: applications to primary care research

In: Grady M, eds. Primary care research: theory and methods. Washington, DC: USDHHS. AHCPR Pub 91-0011:75-81. Johns Hopkins University, Baltimore, MD, USA This paper describes […]

Differences in case mix between CHC users and non users: Washington and Missouri

MDS Associates, Laguna Research Associates. Final report to the Bureau of Primary Health Care. Wheaton, MD, USA: MDS Associates. Wheaton, MD, USA; San Francisco, CA, […]

A comparative analysis of claims-based methods of health risk assessment for commercial populations

Minneapolis, MN, USA: Milliman USA and Park Nicollet Institute Health Research Center. Milliman USA and Park Nicollet Institute Health Research Center, Minneapolis, MN, USA The […]

Effect of patient cost sharing in South Korea: ACG risk-adjusted differences in health care utilization and expenditures among National Health Insurance and Medical Aid enrollees, 2004-2005

Baltimore, MD, USA: Johns Hopkins University (doctoral dissertation). Johns Hopkins University, Baltimore, MD, USA Korea has experienced a period of rapid economic development and industrialization […]

Provider profiling: implementation issues within Florida MediPass

Gainesville, FL, USA: University of Florida. University of Florida, Gainesville, FL, USA Provider profiling use epidemiological methods to compare physician practice  patterns across various dimensions […]

Using the ACG casemix system in population health management programs at Johns Hopkins

BMC Health Serv Res 9:A16. Johns Hopkins HealthCare, Glen Burnie, MD, USA   Introduction: Johns Hopkins HealthCare contracts with the US Department  of Defense (DOD) […]

Who uses exenatide for glucose control in diabetes mellitus?

A retrospective cohort study of a new therapy? Rockville, MD, USA: Agency for Healthcare Research and Quality. Johns Hopkins University, Baltimore, MD, USA BACKGROUND: Exenatide […]

Direct costs of hip fractures among seniors in Ontario

Toronto, ON, Canada: University of Toronto (masters thesis). University of Toronto, Toronto, ON, Canada Osteoporosis is a major public health problem resulting in substantial hip […]

Electronic patient provider communication in diabetes care

Seattle, WA, USA: University of Washington (doctoral dissertation). University of Washington, Seattle, WA, USA Diabetes is a chronic illness of increasing public health importance affecting […]

Measuring health status for risk adjusting capitation payments

Hamilton, NJ, USA: Center for Health Care Strategies. Center for Health Care Strategies, Hamilton, NJ, USA In this report we describe six health status grouping […]

Asthma drug regimen optimality and health services utilization: a population-based analysis in British Columbia

Vancouver, BC, Canada: University of British Columbia (doctoral dissertation). University of British Columbia, Vancouver, BC, Canada BACKGROUND: Drug therapy is the mainstay medical treatment for […]

Identifying People at Increased Risk of Severe Illness from COVID-19 in the UK

During the current pandemic, NHS stakeholders need to identify their most vulnerable patient populations. This short report shares how insights from the ACG System can […]

Introduction to the ACG System

Johns Hopkins Bloomberg School of Public Health Population Based Casemix- An Introduction to the ACG System Dr Peter F. S. Lee

Tuesday-Re-thinking ACG fundamentals-Low

Clalit Profiling Morbidity Burden in Primary Care: Local Calibration of a Case-Mix Model to Account for the Burden Israeli Primary Care Physicians Face Ran D. […]

Monday-US Health Reform-Gootee

MZI HealthCare A Population Health Model for Physician Reimbursement: A Hybrid Approach Greg Gootee, MBA

Monday-Care Coordination II-Jabaar

Discovery Health A Virtually Integrated Care Delivery Model for Complex, High-Needs Patients Riedwaan Jabaar

LookingBackLookingForward

Johns Hopkins Bloomberg School of Public Health Looking Back, Looking Forward: Johns Hopkins ACG System Improving Health Care Worldwide for 30 Years Professor Jonathan P. […]

2014 Reform Preparation: What Health Plans Need to Know Now!

DST Health Solutions 2014 Reform Preparation: What Health Plans Need to Know Now! Teri Mullaney, Chief Strategy Officer

Monday(C5)-Expanding the clinical toolbox for progressive healthcare intervention —Lizelle Steenkamp

Expanding the clinical toolbox for progressive healthcare intervention —Lizelle Steenkamp, Discovery Health 

Tuesday(P2)-Reaching The EMR / e-Health Tipping Point: Implications for the Future of Health Care and Population Health-Jonathan P. Weiner DrPH

Reaching The EMR / e-Health Tipping Point:  Implications for the Future of Health Care and Population Health  —Jonathan P. Weiner, DrPH  Professor of Health Policy […]

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About the ACG System V11.0 Release

In this video, Chad Abrams, M.A.; Director of U.S. Operations, ACG System; briefly describes the Johns Hopkins ACG System highlighting features included in the software’s version 11 release. Learn more.

Post-acute pathways among hip fracture patients: a system-level analysis

Background: Hip fractures among older adults are one of the leading causes of hospitalization and result in significant morbidity, mortality, and health care use. Guidelines […]

Examination of Health System Resources and Costs Associated With Transitioning Cancer Survivors to Primary Care: A Propensity-Score–Matched Cohort Study

Background: Transitioning low-risk cancer survivors back to their primary care provider (PCP) has been shown to be safe but the effect on health system resources […]

Using EMRALD to assess baseline body mass index among children living within and outside communities participating in the Ontario, Canada Healthy Kids Community Challenge

Abstract   Objectives The Healthy Kids Community Challenge is a large-scale, centrally-coordinated, community-based intervention in Ontario, Canada that promotes healthy behaviours towards improving healthy weights […]

The Association Between Continuity of Primary Care and Preventive Cancer Screening in Women With Intellectual Disability

Abstract Women with intellectual disability have low screening rates for breast and cervical cancer. This population-based cohort study examined the association between the level of […]

The Lifestyle Medicine Physician’s Case to Self-Insured Employers: A Business Model for Physicians, a Bargain for Companies

Abstract   A majority of Americans have health care insurance through their employers, the cost for which is rising at an alarming rate. Unfortunately, higher […]

Predicting Short-Term Outcomes After Radical Cystectomy Based on Frailty

Abstract Objective To evaluate the impact of frailty on adverse perioperative outcomes in patients treated with radical cystectomy for bladder cancer. Material and Methods We […]

Production of physician services under fee‐for‐service and blended fee‐for‐service: Evidence from Ontario, Canada

Abstract We examine family physicians’ responses to financial incentives for medical services in Ontario, Canada. We use administrative data covering 2003–2008, a period during which […]

Patient frailty predicts worse perioperative outcomes and higher cost after radical cystectomy

Abstract Background Relatively few studies investigated the importance of frailty in radical cystectomy (RC) patients. We tested the ability of frailty, using the Johns Hopkins […]

Patient-reported symptoms following diagnosis in esophagus cancer patients treated with palliative intent

Summary The majority of patients with esophagus cancer have advanced-stage disease without curative options. For these patients, treatment is focused on improving symptoms and quality […]

Peri‐complication diagnosis of hepatitis C infection: Risk factors and trends over time

Abstract Background & Aims Hepatitis C virus (HCV) is a common and treatable cause of cirrhosis and its complications, yet many chronically infected individuals remain […]

Using Health Plan Authorization Data to Predict Hospitalizations and Readmissions in a Combined Commercial and Medicaid Population

Abstract Health plans develop predictive models to predict key clinical events (eg, admissions, readmissions, emergency department visits). The authors developed predictive models of admissions and […]

Association between socioeconomic deprivation and surgical complications in adults undergoing ankle fracture fixation: a population-based analysis

Abstract Background Few studies have investigated the outcomes of surgical fracture care among socially deprived patients despite the increased incidence of fractures and the inequality […]

Breast cancer diagnosis and treatment wait times in specialized diagnostic units compared with usual care: a population-based study

Abstract Background Breast assessment sites (bass) were developed to provide expedited and coordinated care for patients being evaluated for breast cancer (bca) in Ontario. We […]

Epidemiology and Impact of Spinal Cord Injury in the Elderly: Results of a Fifteen-Year Population-Based Cohort Study

Abstract Objective Although experience suggests a shift in the epidemiology of spinal cord injury (SCI) toward an older demographic, population studies are lacking. We aimed […]

Systematic review on the instruments used for measuring the association of the level of multimorbidity and clinically important outcomes

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 […]

Inequities in access to primary care among opioid recipients in Ontario, Canada: A population-based cohort study

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 […]

Prevalence, determinants, and outcomes of SARS-COV-2 infection among cancer patients. A population-based study in northern Italy

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 […]

Outcomes after the regionalization of care for high-grade endometrial cancers: a population-based study

Abstract Background In June 2013, Ontario Health (Cancer Care Ontario), the agency responsible for advancing cancer care in Ontario, Canada, published practice guidelines recommending that […]

Pre-operative wait times in high-grade non-endometrioid endometrial cancer: Do surgical delays impact patient survival?

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 […]

Patterns Of Multimorbidity Of Patients In Geriatric Care – A Register-Based Cohort Study In Sweden

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 […]

Impact of Social Needs in Electronic Health Records and Claims on Health Care Utilization and Costs Risk-Adjustment Models Within Medicaid Population

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) […]

Creating a Cost-map From Claims Data to Guide Improvement Actions for Children With Asthma

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 […]

Effect of sustained virologic response on liver-related mortality among individuals living with hepatitis C by treatment era: A population-based retrospective cohort study

Abstract Purpose Sustained virologic response (SVR) is a validated surrogate marker for successful hepatitis C virus (HCV) treatment. Historically, interferon-based therapies, the standard of care […]

Risk Profile of Young Adults with Chronic Obstructive Pulmonary Disease

Abstract Background: COPD risk profiles have been described in populations comprised of or including older adults, leaving factors associated with COPD in younger adults overlooked. […]

Variations in multimorbidity measurement in studies evaluating hospitalisation in older adults: a systematic review

Abstract Background Multimorbidity is the coexistence of two or more chronic diseases, and in older adults is more common which can lead to increased rates […]

Risk Adjustment in Capitation Payments to Primary Care Providers

Abstract Background: One of the critical challenges with capitation payment to primary care providers is ensuring that the fixed payments are equitable and adjusted for […]

Patterns of care of gestational trophoblastic disease in Ontario: a population-based study

Abstract Objectives Gestational trophoblastic disease (GTD) is a rare condition that affects reproductive-age women with excellent clinical outcomes if treated appropriately. The study aims to […]