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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 […]

Familial aggregation of childhood health and the socioeconomic gradient of disease: a longitudinal population-based sibling analysis

Winnipeg, MB, Canada: University of Manitoba (masters thesis). University of Manitoba, Winnipeg, MB, Canada The Johns Hopkins ACG(r) Case-Mix System grouped various physician and hospital […]

Impact of rheumatoid arthritis on recognition of hypertension in a medically homed population

Arthritis Rheum 64:S712-S713. University of Wisconsin, Madison, WI, USA BACKGROUND/PURPOSE: Numerous studies report increased cardiovascular disease (CVD) events and others describe increased arterial stiffness in […]

Adjusted Clinical Groups (ACG) and co-morbidity

ImPrim Report D. Karlskrona, Sweden: ImPrim. Blekinge Centre of Competence, Karlskrona, Sweden No abstract

Depression, anxiety disorders, and related health care utilization in the Manitoba Metis population

Winnipeg, MB, Canada: Manitoba Metis Federation. Manitoba Metis Federation, Winnipeg, MB, Canada This report resulted from the need to understand further the findings in the […]

Leicester City CCG Case Study 3

Use of ACG® System output to support distribution of CCG Better Care Fund monies

Resource Allocation Case Study-Government

Sweden became one of the first international adopters of the Johns Hopkins ACG System in the mid 1990s and has expanded its use to cover […]

Poster: Morbidity Burden Resource Use and Quality of Care of Diabetic Patients

Morbidity burden, resource use and quality of care of diabetic patients: A 4-year cohort analysis at a regional hospital in Thailand. Roongkarn Pannarunothai, Buddhachinaraj Hospital, […]

Embedding ACGs in Berkshire

NHS Berkshire Embedding ACGs in Berkshire Karen Grannum Primary Care Business Intelligence Lead

Using the ACG Toolkit to Support Population Monitoring

DST Health Solutions Using the ACG Toolkit to Support Population Monitoring Lisa Kabasakalian

Monday(C3)-Identifying Potentially Actionable Chronic Disease Patterns From Diagnoses Reported in Administrative Claims-Dave Bodycombe

Identifying Potentially Actionable Chronic Disease Patterns From Diagnoses Reported in Administrative Claims —Dave Bodycombe, Johns Hopkins University

Tuesday(C6)-Integration of claim-based diagnoses with diagnoses from General Practitioners (GPs) clinical database records improves the comorbidity description”-Corti

 Integration of claim-based diagnoses with diagnoses from General  Practitioners (GPs) clinical database records improves the comorbidity description” Maria Chiara Corti,  E. Schievano F. Avossa, K. Kinder, […]

What causes ’poly-morbidity’? Searching for triggers of multi-morbidity: tracing patient record 30 years back

Lennart Carlsson, PhD; Gunnar H Nilsson, Professor; Centre for Family Medicine, Karolinska Institutet, Sweden

Beyond Risk Scores: Lisa Kabasakalian, DST Health Solutions

ACG System DST Health Solutions Beyond Risk Scores: Identifying “High-Risk” and “At-Risk” Populations Lisa Kabasakalian

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The ACG System Worldwide

ACG System Executive Director Karen Kinder, PhD, provides a candid tour of the ACG System’s international history and evolution to what is now the most […]

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Population Segmentation Case Study – Government

Three Clinical Commissioning Groups (CCGs) analyzed their local populations as part of a new national initiative to address the care of people who are frail.  Learn more.

Relation between primary care physician supply and diabetes care and outcomes: a cross-sectional study

Background: Higher primary care physician supply is associated with lower mortality due to heart disease, cancer and stroke, but its relation to diabetes care and […]

Home Palliative Service Utilization and Care Trajectory Among Ontario Residents Dying on Chronic Dialysis

Background: Many patients who receive chronic hemodialysis have a limited life expectancy comparable to that of patients with metastatic cancer. However, patterns of home palliative […]

Association Between Wait Time for Transcatheter Aortic Valve Replacement and Early Postprocedural Outcomes

Abstract Background Rapid growth in transcatheter aortic valve replacement (TAVR) demand has translated to inadequate access, reflected by prolonged wait times. Increasing wait times are […]

Variation in Revascularization Practice and Outcomes in Asymptomatic Stable Ischemic Heart Disease

Abstract   Objectives The aims of this study were to assess variation in revascularization of asymptomatic patients with stable ischemic heart disease, identify the predictors of variation, and […]

Trends in Providing Out-of-Office, Urgent After-Hours, and On-Call Care in British Columbia

Abstract   PURPOSE Providing care in alternative (non-office) locations and outside office hours are important elements of access and comprehensiveness of primary care. We examined […]

Impact of Predialysis Psychosocial Conditions on Kidney Transplant Recipient Survival: Evidence Using Propensity Score Matching

Abstract Background: An increased number of end-stage renal disease patients suffer psychosocial conditions and may experience delayed access to transplantation due to listing restrictions. However, […]

Days spent at home in the last 6 months of life: a quality indicator of end of life care in patients with hematologic malignancies

Abstract Despite advances in the management of hematologic malignancies, a significant proportion of patients die of their disease. We used administrative databases in Ontario, Canada […]

Comparison of Cardiovascular Risk Factors and Outcomes Among Practicing Physicians vs the General Population in Ontario, Canada

Abstract IMPORTANCE Although cardiovascular disease is the leading cause of death in most developed countries, little is known about current physicians’ cardiovascular health and outcomes. […]

Overall mortality and causes of death in newly admitted nursing home residents

Abstract Background In spite of a rapidly ageing population, there is a lack of population-based data on mortality among nursing home residents in Southern Europe. […]

The measurement of multimorbidity.

Abstract Overview: The presence of multiple concurrent medical conditions (also known as multimorbidity) is now a common phenomenon, hence the importance of its measurement. Objective: […]

Medication use and its impact on high-cost health care users among older adults: protocol for the population-based matched cohort HiCOSTT study

Abstract Background Health interventions and policies for high-cost health care users (HCUs) who are older adults need to be informed by a better understanding of […]

Overall Health Care Cost During the Year Following Diagnosis of Colorectal Cancer Stratified by History of Colorectal Evaluative Procedures

Abstract Background The cost-effectiveness of colorectal screening has been modeled; however, the cost of health care following the diagnosis of colorectal cancer has not been […]

Association Between Switching to a High-Deductible Health Plan and Major Cardiovascular Outcomes

Abstract Objective To describe the association between enrollment in high-deductible health plans and the risk of major adverse cardiovascular outcomes. Design, Setting, and Participants This […]

Emergency department use in people who experience imprisonment in Ontario, Canada

Abstract Objectives The aims of this study were to describe emergency department (ED) utilization by people in provincial prison and on release, and to compare […]

Healthcare services use and costs for a cohort of high needs elderly diabetic patients

Abstract Background The worldwide prevalence of diabetes mellitus is increasing, which especially involves people aged >65 years. A recent study also found that almost 75% […]

Individual and social determinants of SARS-CoV-2 testing and positivity in Ontario, Canada: a population-wide study

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 […]

The influence of frailty on postoperative complications in geriatric patients receiving single-level lumbar fusion surgery

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 […]

Medical use of cocaine and perioperative morbidity following sinonasal surgery—A population study

Abstract Background Topical cocaine is favoured by many surgeons for sinonasal surgery due to its superior vasoconstrictive and anesthetic properties. However, historical reports suggesting cocaine […]

Risk Factors and Outcomes of Early Hospital Readmission in Canadian Kidney Transplant Recipients: A PopulationBased Multi-Center Cohort Study

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 […]

Understanding Deductible and Reimbursement Maximum:A Study of Rural China’s Tiered Medical System

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. […]

Claims-based pharmacy markers for comprehensive medication management program case identification: Validation against concurrent and prospective healthcare costs and utilization

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 […]

Estimating The Marginal Productivity Of Health Technology Adoption

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 […]

Care Coordination Engagement Patterns in Long-Term Patients

Abstract OBJECTIVE: Health care networks are increasingly turning to programs that provide office-based care coordination to high-cost, high-need patients to control preventable health care costs. […]

More Employers Offer Preventive Drug Lists Over Time

ABSTRACT Objective: To describe trends in employer preventive drug list (PDL) offerings and associations of employer PDL offerings with employer and workforce characteristics. Study Design: […]

Percutaneous Endoscopic Gastrostomy (PEG) Tube Placement in Frail Patients: Exploring Postprocedural Outcomes and Readmissions Using the National Readmission Database, 2018–2020

Abstract Objective Percutaneous endoscopic gastrostomy (PEG) tube placement is a common gastrointestinal procedure that provides nutrition, fluids, and medications to patients with inadequate oral intake. […]

Frailty and body composition as predictors of postoperative outcomes in patients with epithelial ovarian cancer undergoing neoadjuvant chemotherapy

Abstract Objective To assess whether the five-factor modified frailty index (mFI5) can predict adverse post-operative outcomes in patients with epithelial ovarian cancer (EOC) undergoing interval […]

Predicting Return Home After Moderate-to-Severe Traumatic Brain Injury

Abstract Background and Objectives Days alive and at home (DAH) is a validated outcome measure that captures health care transitions between time spent at home […]

Review of Risk Factors for Opioid Misuse and Addiction Following Traumatic Injury

Abstract Traumatic injuries represent a significant public health challenge, affecting millions worldwide annually and necessitating acute pain management that frequently involves the use of opioid […]

Factors affecting lung cancer stage at diagnosis and receipt of surgery in Ontario: A population-based analysis

Abstract Lung cancer is the leading cause of cancer mortality in Canada, with most cases diagnosed at advanced stage. Despite universal healthcare, social determinants of […]

Psychiatric disorder diagnoses and adverse psychiatric outcomes among pregnant and postpartum adolescents in Ontario, Canada: a retrospective, population-based cohort study

Summary Background Adolescents appear to be at increased risk of mental illness during pregnancy and the first year postpartum, although most studies to date are […]

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 […]

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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 […]

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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 […]