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The effect of nurse care management on multimorbid patients’ hospital utilization: a comparative-controlled trial and an exploratory cohort study

Abstract Multimorbidity, defined as the presence of two or more chronic conditions in one individual, poses substantial challenges to patients and healthcare systems, yet evidence […]

The value of recovery after spinal cord injury: long-term healthcare costs in relation to home time in a population-based cohort

Abstract BACKGROUND CONTEXT Traumatic spinal cord injury (SCI) is associated with substantial long-term healthcare utilization. While prior studies have quantified costs, few have contextualized expenditures […]

Does End-of-Life Care Differ for Anglophones and Francophones? A Retrospective Cohort Study of Decedents in Ontario, Canada

Abstract Background: Approximately half of decedents in Ontario, Canada, receive some palliative care, but little is known about the influence of language on the nature of […]

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Identifying High Risk COVID-19 Patients Q&A

During the current health care crisis, health systems, health plans and governments urgently need to identify their most vulnerable patient populations. The Johns Hopkins ACG […]

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Predictive Modeling Part I – An Introduction to the Basics

This webinar is an introduction to the basics of predictive modelling and provides an overview of the predictive models that are available within the Johns […]

Comparative effectiveness of olmesartan and other angiotensin receptor blockers in diabetes mellitus: retrospective cohort study

Hypertension 63:977-983. University of Alberta, Edmonton, AB, Canada Olmesartan has been linked with increased risk of cardiovascular mortality and sprue-like enteropathy. We compared outcomes between […]

Variations in primary care physician referral rates

Health Serv Res 34:323-329. University of Rochester, Rochester, NY, USA OBJECTIVE: To examine primary care physician referral rate variations, including their extent and their stability […]

Increased suicidal activity following major trauma: a population-based study

J Trauma Acute Care Surg 76:180-184. University of Manitoba, Winnipeg, MB, Canada; University of California San Diego, San Diego, CA, USA; University of Regina, Regina, […]

Multimorbidity in risk stratification tools to predict negative outcomes in adult population

Eur J Intern Med 26:182-189. Basque Institute for Healthcare Innovation, Barakaldo, Spain; Università Cattolica del Sacro Cuore, Rome, Italy; Agenzia Italiana del Farmaco (AIFA), Rome, […]

Direct medical costs and source of cost differences across the spectrum of cognitive decline: A population-based study

Alzheimers Dement. Mayo Clinic, Rochester, MN, USA; K Long Health Economics Consulting LLC, St. Paul, MN, USA; AbbVie, North Chicago, IL, USA BACKGROUND: Objective cost […]

Physicians and prepaid group practices

Health Aff W4:76-78. Commonwealth Fund, New York, NY, USA Prepaid group practices (PGPs) are complex organizations that directly combine prepayment for health care with a […]

Impact of case mix severity on quality improvement in a patient-centered medical home (PCMH) in the Maryland Multi-Payor Program

J Am Board Fam Med 29:116-125. University of Maryland School of Medicine, Baltimore, MD, USA; University of Maryland School of Pharmacy, Baltimore, MD, USA; Department […]

A population-based study comparing patterns of care delivery on the quality of care for persons living with HIV in Ontario

BMJ Open 5:e007428. Bruyère Research Institute, Ottawa, ON, Canada; University of Ottawa, Ottawa, ON, Canada; Ottawa Hospital Research Institute, Ottawa, ON, Canada; Institute for Clinical […]

Trends and determinants of prescription drug use during pregnancy and postpartum in British Columbia, 2002-2011: a population-based cohort study

PLoS One 10:e0128312. University of British Columbia, Vancouver, BC, Canada PURPOSE: To describe trends, patterns, and determinants of prescription drug use during pregnancy and postpartum. […]

The use of long-acting beta2- agonists as monotherapy in children and adults

J Popul Ther Clin Pharmacol 20:e1. University of British Columbia, Vancouver, BC, Canada; St. Paul’s Hospital, Vancouver, BC, Canada BACKGROUND: In asthma, it is recommended […]

Selection bias from requiring patients to give consent to examine data for health services research

Arch Fam Med 9:1111-1118. Department of Family Practice, Medical College of Virginia, Virginia Commonwealth University, Fairfax, VA, USA BACKGROUND: New rulings nationwide require health services […]

Adjusted Clinical Groups: predictive accuracy for Medicaid enrollees in three states

Health Care Financ Rev 24:43-61. Rollins School of Public Health, Emory University, Atlanta, GA, USA Actuarial split-sample method were used to assess predictive accuracy of […]

The effect of socioeconomic status on bone density testing in a public health-care system

Osteoporos Int 18:153-158. Radiology, University of Manitoba, Winnipeg, MB, Canada INTRODUCTION AND HYPOTHESIS: An inverse relationship exists between socio-economic status (SES) and osteoporotic fractures. In […]

Medical and psychosocial diagnoses in women with a history of intimate partner violence

Arch Intern Med 169:1692-1697. Department of Human Development and Family Science, Ohio State University, Columbus, OH, USA BACKGROUND: We characterized the relative risk of a […]

Heart failure in the family practice: a study of the prevalence and co-morbidity

Fam Pract 28:128-133. Unidad de Bioingenieria y Telemedicina, Hospital Universitario Puerta de Hierro, Majadahonda, Spain BACKGROUND: Heart failure (HF) is a health problem that particularly […]

Adapting the Rx-Risk-V for mortality prediction in outpatient populations

Med Care 44:793-797. Houston Center for Quality of Care and Utilization Studies, Michael E. DeBakey Veterans Affairs Medical Center, Houston, TX, USA OBJECTIVES: We sought […]

Multimorbidity and its measurement

Health Policy 103:3-8. Department of Health Policy and Management, Johns Hopkins University, Baltimore, MD, USA Multimorbidity is increasing in frequency. It can be quantitatively measured […]

Explaining primary healthcare pharmacy expenditure using classification of medications for chronic conditions

Health Policy 103:9-15. Research Centre for Health Care Economics and Management, Universitat Politècnica de València, Valencia, Spain BACKGROUND: The Valencian Autonomous Community (Spain) has implemented […]

Randomized trial of depression follow-up care by online messaging

J Gen Intern Med 26:698-704. Group Health Research Institute, Seattle, WA, USA BACKGROUND: Quality of antidepressant treatment remains disturbingly poor. Rates of medication adherence and […]

Types of morbidity and categories of patients in a Swedish county. Applying the Johns Hopkins Adjusted Clinical Groups System to encounter data in primary health care

Scand J Prim Health Care 22:174-179. Center for Family Medicine, Department of Clinical Science, Karolinska Institute, Stockholm, Sweden OBJECTIVE: To elucidate types of morbidity and […]

Medical comorbidity among youth diagnosed with bipolar disorder in the United States

J Clin Psychiatry 70:1461-1466. Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA OBJECTIVE: This study examines the […]

Common comorbidity scales were similar in their ability to predict health care costs and mortality

J Clin Epidemiol 57:1040-1048. Indiana University Center for Aging Research, Indianapolis, IN, USA OBJECTIVE: To compare the ability of commonly used measures of medical comorbidity […]

Diagnostic scope of and exposure to primary care physicians in Australia, New Zealand, and the United States: cross sectional analysis of results from three national surveys

BMJ 334:1261. Division of General Internal Medicine, University of California San Francisco, San Francisco General Hospital, San Francisco, CA, USA. OBJECTIVES: To compare mix of […]

Influence of body mass index on the choice of therapy for depression and follow-up care

Obesity 21:e303-e313. Group Health Research Institute, Group Health Cooperative, Seattle, WA, USA OBJECTIVE: Overweight and obese patients commonly suffer from depression and choice of depression […]

Adverse events in elderly users of antipsychotic pharmacotherapy in the province of Manitoba: a retrospective cohort study

J Clin Psychopharmacol 33:24-30. University of Manitoba, Winnipeg, MB, Canada. BACKGROUND: Antipsychotic medications have been widely used in elderly patients for treatment of a variety […]

Emergency department use by the rural elderly

J Emerg Med 18:289-297. Department of Family Medicine, University of Washington, Seattle, WA, USA This study uses Medicare data to compare emergency department (ED) use […]

The potential of risk adjustment for the Military Health System TRICARE Program

Mil ed 170:964-971. AdvanceMed/CSC, Plaza America Drive, Reston, VA, USA Using industry leading methods and software products, this article explores the potential for health risk […]

The effects of interdisciplinary outpatient geriatrics on the use, costs and quality of health services in the fee-for-service environment

Aging Clin Exp Res 20:556-561. Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA BACKGROUND AND AIMS: To evaluate the effect of interdisciplinary outpatient […]

The relationship between effectiveness and costs measured by a risk-adjusted case-mix system: multicentre study of Catalonian population data bases

BMC Public Health 9:202. Directorate of Planning, Badalona Serveis Assistencials SA, Badalona, Barcelona, Spain BACKGROUND: The main objective of this study is to measure the […]

Adjusted Clinical Groups use at a Spanish primary care center: a retrospective, population-based study

Rev Panam Salud Publica 27:49-55. Published in Spanish. Dirección de Planificación, Badalona Serveis Assistencials, S.A., Barcelona, Spain OBJECTIVES: To evaluate the results of implementing a […]

What is the comparative health status and associated risk factors for the Metis? A population-based study in Manitoba, Canada

BMC Public Health 11:814. Manitoba Centre for Health Policy, University of Manitoba, Winnipeg, MB, Canada BACKGROUND: Métis are descendants of early 17th century relationships between […]

Impact of bariatric surgery on health care utilization and costs among patients with diabetes

Med Care 50:58-65. Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA BACKGROUND: The effect of bariatric surgery […]

Case-mix adjusting performance measures in a veteran population: pharmacy- and diagnosis-based approaches

Health Serv Res 38:1319-1337. VA Puget Sound Health Care System, Seattle, WA, USA OBJECTIVE: To compare the rankings for health care utilization performance measures at […]

Risk adjusting capitation: applications in employed and disabled populations

Health Care Manag Sci 3:101-109. Department of Health Services, University of Washington, Seattle, WA, USA Risk adjustment may be a sensible strategy to reduce selection […]

Use of risk adjustment in setting budgets and measuring performance in primary care I: how it works

BMJ 323:604-607. School of Public Policy, University College London, London, UK No abstract PMID: 11557709 PMCID: PMC55577

Are low-income elderly patients at risk for poor diabetes care?

Diabetes Care 27:1060-1065. Colorado Foundation for Medical Care, Denver, CO, USA OBJECTIVE: Diabetes is common among low-income elderly, dual-eligible (DE) Medicare/Medicaid patients resulting in significant […]

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) […]

Keep it simple? Predicting primary health care costs with clinical morbidity measures

J Health Econ 35C:109-122. University of Bristol, Bristol, UK; University of York, York, UK Models of the determinants of individuals’ primary care costs can be […]

Impact of a high-deductible health plan on outpatient visits and associated diagnostic tests

Med Care 52:86-92. Harvard University; Harvard Medical School; Harvard Pilgrim Healthcare Institute, Harvard Medical School, Boston, MA, USA BACKGROUND: By shifting a greater share of […]

Vitamin D, asthma prevalence and asthma exacerbations: a large adult population-based study

Allergy. Allergy and Clinical Immunology Unit, Meir Medical Center, Kfar Saba, Israel; Sackler Faculty of Medicine, Tel Aviv University, Israel. BACKGROUND: The impact of low […]

Assessing Markers From Ambulatory Laboratory Tests for Predicting High-Risk Patients

ABSTRACT Objectives: This exploratory study used outpatient laboratory test results from electronic health records (EHRs) for patient risk assessment and evaluated whether risk markers based on […]

Profils de multimorbidite et caracteristiques demographiques – patients inscrits dans les groupes de medecine de famille de Montreal (GMF)

Montreal, QC, Canada: Montreal Health and Social Services Agency. Montreal Health and Social Services Agency, Montreal, QC, Canada La coexistence de plusieurs maladies chroniques est […]

Metformin use is associated with lower cervical cancer specific mortality

Radiation Oncology 93:S10. University of Toronto, Toronto, ON, Canada; Women’s College Hospital, Toronto, ON, Canada Purpose/Objective(s): While meta-analysis has shown metformin use in diabetic patients […]

Impact of physician and center case volume on the adequacy of cardiac monitoring during adjuvant trastuzumab in breast cancer

2013 Breast Cancer Symposium. Abstract 128. J Clin Oncol 31 (suppl 26; abstr 128). University of Toronto, Toronto, ON, Canada; St. Michael’s Hospital, Toronto, ON, […]

Ambulatory Care Groups as a primary care patient classification system

Cuadernos de Gestión 6:19-24. Published in Spanish. Fundació Jordi Gol i Gurina, Barcelona, Spain No abstract

Adjusted Clinical Groups – an instrument to predict resource use: a population-based healthcare management tool

Gesundheits- und Sozialpolitik 1-2:8-15. Published in German. Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA Advances in information technology, electronic billing, and diagnostic […]

Applicability of predictive risk groupers to MHS data model. Deliverable 8: interim analysis of results

Reston, VA, USA: AdvanceMed Corp. AdvanceMed Corp., Reston, VA, USA AdvanceMed Corporation, a DynCorp company, is supporting the TRICARE Management Activity (TMA) and its health […]

Risk adjustment for asthma: variations by methodology and implications for providers

Working paper: Informed Purchasing Series. Hamilton, NJ, USA: Center for Health Care Strategies. Center for Health Programs Development and Management, University of Maryland, Baltimore County, […]

From theory to application: the implementation of risk adjustment for Minnesota Medicaid

Minneapolis, MN, USA: Park Nicollet Institute, Minnesota Department of Health, Minnesota Department of Human Services. Park Nicollet Institute and Minnesota Department of Health, Minneapolis, MN, […]

Impact of continuity of care and provider factors on medication adherence in patients with hypertension

Baltimore, MD, USA: Johns Hopkins University (doctoral dissertation). Johns Hopkins University, Baltimore, MD, USA STATEMENT OF THE PROBLEM: Hypertension is one of the most common […]

Understanding approaches to case-mix assessment and case-mix adjustment

JHQ Online :W5-24 – W5-29. McKesson Medical Management Group, Newton, MA. Rising healthcare costs coupled with diminishing financial  resources are stimulating changes in the organization […]

Diabetes, gender and neighbourhood ethnicity: inequalities in healthcare resource utilization

Canadian Journal of Diabetes 33:281. Provincial Health Services Authority, Vancouver, BC, Canada AIMS: Lower utilization of medical resources by immigrants are often observed in self-reported […]

Mortalidad por cualquier causa e incidencia de enfermedad cardiovascular en hipertensos con perfil tipo Anglo-Scandinavian Cardiac Outcomes Trial en un ambito poblacional espanol

Aten Primaria 42:420-430. Published in Spanish. Dirección de Planificación, Badalona Serveis Assistencials S.A., Badalona, Barcelona, Spain OBJECTIVES: Mediterranean populations are traditionally considered to be associated […]

Development of a Medical Productivity Index for health insurance beneficiaries

Insurance Markets and Companies: Analyses and Actuarial Computations 2:7-15. University of Minnesota, Minneapolis, MN, USA In this paper, a Medical Productivity Index (MPI) is proposed […]

Des indicateurs de qualité à l’intention des professionnels et des gestionnaires des services de première ligne

Institut national d’excellence en santé et en services sociaux (INESSS). Rapport rédigé par Marie-Dominique Beaulieu, Marie‐Pascale Pomey, Brigitte Côté, Claudio Del Grande, Monia Ghorbel, Phuong […]

Social Housing in Manitoba

Winnipeg, MB, Canada: Manitoba Centre for Health Policy. Manitoba Centre for Health Policy, Winnipeg, MB, Canada The Manitoba Centre for Health Policy (MCHP) in conjunction […]

Clinical integration of the chronic patient

Enfermeria Clnica 24:35-43. Published in Spanish. Gerencia del Servicio de Salud de Castilla-La Mancha (SESCAM), Toledo, Spain Castilla-La Mancha Health Service is developing the integration […]

Risk Stratification – An introduction to the basics

This document provides a high-level overview of what risk stratification is its relevance to the health service and some things to consider when using risk […]

Thai Health Financing Arrangements

Naresuan University Ambulatory casemix systems and Thai health financing arrangements Supasit Pannarunothai Faculty of Medicine

Tuesday-Utilization-Borgquist

BMC Public Health Co-morbidity and Health Care Utilisation Five Years Prior to Diagnosis for Depression: A Register-Based Study in a Swedish Population David Andersson Henrik […]

Monday-Care Coordination I-Muniz

Johns Hopkins ACG System The Development of a Coordination Risk Measure Patricio Muñiz

Improving Patient Care

Cricket Green Medical Practice, Mitcham, Surrey Improving Patient Care Using Risk Profiling in Primary Care Dr Simon Gilbert, GP

Tuesday(C6)-Bridging the Gap Between Payer Data and EHR Data —Rohan D’Souza

Bridging the Gap Between Payer Data and EHR Data —Rohan D’Souza, eClinicalWorks

Sunday-Overview of Version 11: Enhancements and Features-Salls

OVERVIEW OF VERSION 11: ENHANCEMENTS AND FEATURES  Overview of Version 11: Enhancements and Features —Amy Salls, DST Health Solutions

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Overview of the Johns Hopkins ACG System

Karen Kinder, PhD, MBA, Executive Director, ACG System, gives an overview of the ACG System and its various applications to solve health care challenges worldwide. Dr. Kinder highlights how the different users including health organizations, national and regional health authorities, clinic directors, and practitioners use the ACG System to improve accuracy and fairness in evaluating performance, identifying individuals at high risk, forecasting health care utilization, or setting equitable payment rates.

Outcomes Among Patients Discharged From the Emergency Department With a Diagnosis of Peripheral Vertigo

Objective: We aimed to determine the risk of short- and long-term stroke, as well as accidental injury, in patients discharged from an emergency department who […]

Evaluating the Impact of Prescription Fill Rates on Risk Stratification Model Performance

Risk adjustment models are traditionally derived from administrative claims. Prescription fill rates—extracted by comparing electronic health record prescriptions and pharmacy claims fills —represent a novel […]

First Use of a Population Health Management Strategy in Dutch Primary Health Care

Abstract Introduction: Recently, in Dutch health care the focus is shifting from a disease oriented approach to a more population based approach. Since in The […]

Impactibility Model for Population Health Management in High-Cost Elderly Heart Failure Patients: A Capture Method Using the ACG System

Abstract The aim of the present study is to use the ACG (Adjusted Clinical Groups) System to create an impactibility model by identifying homogeneous clinical […]

The Value of Unstructured Electronic Health Record Data in Geriatric Syndrome Case Identification

Abstract Objectives To examine the value of unstructured electronic health record (EHR) data (free‐text notes) in identifying a set of geriatric syndromes. Design Retrospective analysis […]

A Multi-sourced Data Analytics Approach to Measuring and Assessing Biopsychosocial Complexity: The Vancouver Community Analytics Tool Complexity Module (VCAT-CM)

Abstract Operationalization of the fundamental building blocks of primary care (i.e. empanelment, team-based care and population management) within the context of Community Health Centers requires […]

Effectiveness and Safety of Inhaled Corticosteroids in Older Individuals with Chronic Obstructive Pulmonary Disease and/or Asthma. A Population Study

Abstract Rationale Inhaled corticosteroids (ICS) are established medications for the management of both asthma and chronic obstructive pulmonary disease (COPD), two common chronic airway diseases. […]

Symptom burden among head and neck cancer patients in the first year after diagnosis: Association with primary treatment modality

Abstract Purpose Head and neck cancer (HNC) and its treatment affects quality of life, with significant symptom burden. The main objectives of this study were […]

Trends in cardiovascular care and event rates among First Nations and other people with diabetes in Ontario, Canada, 1996–2015

Abstract Background Rates of cardiovascular disease among people with diabetes have declined over the last 20–30 years. To determine whether First Nations people have experienced […]

Temporal condition pattern mining in large, sparse electronic health record data: A case study in characterizing pediatric asthma

Abstract Objective This study introduces a temporal condition pattern mining methodology to address the sparse nature of coded condition concept utilization in electronic health record […]

Assessing the geographical distribution of comorbidity among commercially insured individuals in South Africa

Abstract Background Comorbidities are strong predictors of current and future healthcare needs and costs; however, comorbidities are not evenly distributed geographically. A growing need has […]

A population-based study comparing outcomes for patients with metastatic castrate resistant prostate cancer treated by urologists or medical oncologists with first line abiraterone acetate or enzalutamide

Abstract Objectives To compare toxicity and all-cause mortality for mCRPC patients receiving first line oral systemic therapy prescribed by medical oncologists and urologists. Methods Population-based […]

Accidental injury, self‐injury, and assault among children of women with schizophrenia: a population‐based cohort study

Abstract Objective We aimed to compare the risk for injury overall and by intent (accidental injury, self‐injury, and assault) among children born to women with […]

Development and validation of the Cambridge Multimorbidity Score

Abstract BACKGROUND Health services have failed to respond to the pressures of multimorbidity. Improved measures of multimorbidity are needed for conducting research, planning services and […]

Frailty is highly prevalent in specific cardiovascular diseases and females, but significantly worsens prognosis in all affected patients: A systematic review

Abstract Objective Cardiologists are more often confronted with older (>60 years) cardiovascular disease (CVD) patients. These patients have particular needs in clinical care because, for […]

Multimorbidity and chronic diseases among undocumented migrants: evidence to contradict the myths

Abstract Background There is little verified information on the global health status of undocumented migrants (UMs). Our aim is to compare the prevalence of the […]

Impact of Neighborhood Social and Environmental Resources on Medicaid Spending

Abstract Introduction In an era of COVID-19, Black Lives Matter, and unsustainable healthcare spending, efforts to address the root causes of health are urgently needed. […]

Development of measurable criteria to identify and prioritize patients for inclusion in comprehensive medication management programs within primary care settings

ABSTRACT BACKGROUND Pharmacists optimize medication use and ensure the safe and effective delivery of pharmacotherapy to patients using comprehensive medication management (CMM). Identifying and prioritizing […]

Emergency department use and hospital admission in children following ambulatory surgery: a retrospective population-based cohort study

ABSTRACT Introduction Paediatric ambulatory surgery (same day surgery and planned same day discharge) is more frequently being performed more in Canada and around the world; […]

Opioid Use after Nephrectomy for Kidney Cancer in Ontario: A Population-Based Study

Abstract Objective To compare the odds of early and prolonged post-operative opioid use in patients undergoing minimally invasive surgery (MIS) versus open surgery for nephrectomy. […]

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. […]

Population risk stratification tools and interventions for chronic disease management in primary care: a systematic literature review

Abstract Background Population risk stratification (RS) tools have been proposed to tailor interventions, prioritize resources, and proactively manage high-risk individuals with chronic diseases in primary […]

Enhancing Depression Identification and Stratification with a Claims-Based Analytical Framework

Abstract Depression, a prevalent health condition, substantially impacts both socioeconomic outcomes and individual wellbeing. Despite the availability of diagnostic tools, existing approaches for identifying depression […]

Association of frailty with outcomes of patients undergoing transvenous lead removal for cardiac implantable electronic device infections in the United States

Abstract Background Frailty, marked by reduced physiological resilience, is associated with adverse outcomes in patients undergoing various cardiovascular procedures. The rising incidence of cardiac implantable […]

Long-term healthcare resource use and cost associated with COVID-19 disease from a health system perspective. An equity-focused population-based cohort study

Abstract SARS-CoV-2 strained Ontario’s health system, with social determinants of health (SDH) underexplored in cost analyses. We examined COVID-19 attributable healthcare resource use and costs […]