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Documents

Documents

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 […]

ACG-modell kan forutsaga vilka som blir hogkonsumenter av sjukvard

Lakartidningen: Published in Swedish. Health Department, Area Monitoring and Analysis , VästraGotaland, Sweden We describe a method, which uses already existent administrative data to identify […]

Understanding geographic variation in health care costs in British Columbia

Vancouver, BC, Canada: University of British Columbia (doctoral dissertation). University of British Columbia, Vancouver, BC, Canada Amidst concerns about escalating health spending, examining variation in […]

Strategies for assessing health plan performance on chronic diseases: selecting performance indicators and applying health-based risk adjustment

Hamilton, NJ, USA: Center for Health Care Strategies. University of Maryland, Baltimore County, and Johns Hopkins Bloomberg School of Public Health, USA As Medicaid managed […]

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

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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.

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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.

The Association of Frailty With Outcomes and Resource Use After Emergency General Surgery: A Population-Based Cohort Study

BACKGROUND: Older patients undergoing emergency general surgery (EGS) experience high rates of postoperative morbidity and mortality. Studies focused primarily on elective surgery indicate that frailty […]

Indianapolis Provider’s Use Of Wraparound Services Associated With Reduced Hospitalizations And Emergency Department Visits

ABSTRACT Recent changes to US reimbursement policies are increasingly holding providers financially accountable for patients’ health. Providing nonmedical services in conjunction with primary care—known as […]

Healthcare costs and utilization associated with high-risk prescription opioid use: a retrospective cohort study

Abstract Background Previous studies on high-risk opioid use have only focused on patients diagnosed with an opioid disorder. This study evaluates the impact of various […]

Nonsteroidal anti-inflammatory drug use and risk of acute kidney injury and hyperkalemia in older adults: a population-based study

Abstract   Background Clinical guidelines caution against nonsteroidal anti-inflammatory drug (NSAID) use in older adults. The study objective was to quantify the 30-day risk of […]

Development of Alzheimer disease in old major depressive patients based upon their health status: A retrospective study in Taiwan

Abstract   This study is conducted to investigate the association between major depressive disorder and the subsequent development of Alzheimer disease (AD) in elderly patients […]

Symptom trajectories and predictors of severe symptoms in pancreatic adenocarcinoma at the end-of-life: a population based analysis of 2,538 patients

Abstract Background We evaluated symptom trajectories and predictors of reporting severe symptoms in the last 6 months of life among non-resected pancreatic adenocarcinoma (PAC) decedents. […]

Cardiovascular Consequences of Obstructive Sleep Apnea in Women: A Historical Cohort Study

Abstract Objective Background: Evidence on sex differences in the association between obstructive sleep apnea (OSA) and cardiovascular outcomes is limited and controversial. We conducted a […]

Is Frailty Associated With Worse Outcomes After Head and Neck Surgery? A Narrative Review

Abstract Objective Frailty has emerged as an important determinant of many health outcomes across various surgical specialties. We examined the published literature reporting on frailty […]

The Impact of Team-Based Primary Care on Guideline-Recommended Disease Screening

Abstract Introduction Family Medicine Groups, implemented in Quebec in 2002, are interprofessional primary care teams designed to improve timely access to high-quality primary care. This […]

Identification of Prenatal Opioid Exposure Within Health Administrative Databases

Abstract BACKGROUND: Health administrative data offer a vital source of data on maternal prenatal opioid exposure (POE). The impact of different methods to estimate POE, especially […]

Sepsis-Associated Mortality, Resource Use, and Healthcare Costs: A Propensity-Matched Cohort Study

Abstract Objectives: To examine long-term mortality, resource utilization, and healthcare costs in sepsis patients compared to hospitalized nonsepsis controls. Design: Propensity-matched population-based cohort study using administrative data. […]

Mental Health Services Provision in Primary Care and Emergency Department Settings: Analysis of Blended Fee-for-Service and Blended Capitation Models in Ontario, Canada

Abstract Background Treating mental illnesses in primary care is increasingly emphasized to improve access to mental health services. Although family physicians (FPs) or general practitioners […]

Associations of clinically recognized vs unrecognized vertebral fracture with mortality

Abstract Purpose Our purpose was to contrast mortality associated with clinically undiagnosed prevalent vertebral fracture recognized on densitometric vertebral fracture assessment (VFA) and prior clinically […]

Intensity of End-of-Life Care in a Cohort of Commercially Insured Women With Metastatic Breast Cancer in the United States

ABSTRACT Purpose There is limited evidence on the intensity of end-of-life (EOL) care for women < 65 years old, who account for about 40% of […]

High‐deductible health plans and low‐value imaging in the emergency department

Abstract Objective To examine the effect of an employer‐mandated switch to high‐deductible health plans (HDHP) on emergency department (ED) low‐value imaging. Data Sources Claims data […]

Primary care-based smoking cessation treatment and subsequent healthcare service utilisation: a matched cohort study of smokers using linked administrative healthcare data

ABSTRACT Background No research has assessed the individual-level impact of smoking cessation treatment delivered within a general primary care patient population on multiple forms of […]

Association between chronic bladder catheterisation and bladder cancer incidence and mortality: a population based retrospective cohort study in Ontario, Canada

Abstract Objectives To compare the risk of bladder cancer and bladder cancer mortality among patients with chronic bladder catheterisation (indwelling or intermittent) to patients from […]

Operationalizing Outpatient Palliative Care Referral Criteria in Lung Cancer Patients: A Population-Based Cohort Study Using Health Administrative Data

Abstract Background Early referral of cancer patients for palliative care significantly improves the quality of life. It is not clear which patients can benefit from […]

Association of bilateral salpingo-oophorectomy with all cause and cause specific mortality: population based cohort study

Abstract Objectives To determine if bilateral salpingo-oophorectomy, compared with ovarian conservation, is associated with all cause or cause specific death in women undergoing hysterectomy for […]

COVID-19 Hospitalizations, Intensive Care Unit Stays, Ventilation, and Death Among Patients With Immune-mediated Inflammatory Diseases Compared to Controls

Abstract Objective To investigate coronavirus disease 2019 (COVID-19) hospitalization risk in patients with immune-mediated inflammatory diseases (IMIDs) compared with matched non-IMID comparators from the general […]

The effect of disease co-occurrence measurement on multimorbidity networks: a population-based study

Abstract Background Network analysis, a technique for describing relationships, can provide insights into patterns of co-occurring chronic health conditions. The effect that co-occurrence measurement has […]

Association of State Insulin Out-of-Pocket Caps With Insulin Cost-Sharing and Use Among Commercially Insured Patients With Diabetes: A Pre–Post Study With a Control Group

Abstract Background Twenty-five states have implemented insulin out-of-pocket (OOP) cost caps, but their effectiveness is uncertain. Objective To examine the effect of state insulin OOP […]

Impact of Patient Demographics, Surgeon Volume, and Hospital Type on Distal Radius Fracture Surgery Outcomes: A Population-Based Study

Abstract Purpose This study aimed to evaluate the impact of patient demographics, surgeon volume, and hospital type on composite outcomes, infection, and revision following surgery […]

Postoperative Opioid Prescribing Among Adults with Disabilities After a Medicare Opioid Limit Policy

Abstract Objective: Determine whether a Medicare 7-day limit on initial opioid prescriptions (effective January 1, 2019) was associated with reductions in duration, dosage, and subsequent […]

The effectiveness of WhatsApp messages on the uptake of screening mammography: a randomized controlled trial

Abstract Objectives Breast screening and early detection have positively influenced survival rates for breast cancer. We conducted a randomized-controlled trial involving 7235 eligible members of […]

Systemic therapies for psoriatic disease and serious adverse events in older adults: A population-based cohort study

Systemic therapies for psoriasis and psoriatic arthritis (PsA) have the potential to cause serious adverse events (SAEs), particularly among older adults (Garcia-Doval et al, 2012; Lavan […]

Mammographic screening and time to breast cancer diagnosis among immigrants and long-term residents in Ontario

Abstract Background Biennial breast screening enables timely diagnosis, a critical determinant of survival. However, this benefit depends on navigating complex healthcare systems where immigrant women […]

Prevalence of prescribed opioid claims among persons with non-traumatic spinal cord dysfunction in Ontario, Canada: a population-based retrospective cohort study

Abstract Study Design Cohort study. Objectives To determine the prevalence and to identify predictors of prescription opioid use among persons with non-traumatic spinal cord dysfunction […]

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 […]

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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 […]

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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.

Developing a dashboard to help measure and achieve the triple aim: a population-based cohort study

BMC Health Serv Res 14:363. McMaster University, Hamilton, ON, Canada BACKGROUND: Health system planners aim to pursue the three goals of Triple Aim: 1) reduce […]

Performance of the ACG case-mix system in two Canadian provinces.

Med Care 39:86-99. Centre for Health Services and Policy Research, University of British Columbia, Vancouver, BC, Canada BACKGROUND: While the adjusted clinical group (ACG) system […]

Identifying possible indicators of systematic overuse of health care procedures with claims data

Med Care 52:157-163. Department of Health Policy and Management, Johns Hopkins University, Baltimore, MD, USA BACKGROUND: Health care quality is frequently described with measures representing […]

Evaluating diagnosis-based case-mix measures: how well do they apply to the VA population?

Med Care 39:692-704. Center for Health Quality, Outcomes and Economic Research, Bedford VAMC, MA, USA BACKGROUND: Diagnosis-based case-mix measures are increasingly used for provider profiling, […]

The association between continuity of care and the overuse of medical procedures

JAMA Intern Med Johns Hopkins University, Baltimore, MD, USA Importance: Both the overuse of unnecessary medical procedures and poor continuity of care are thought to […]

Effect of attribution length on the use and cost of health care for a pediatric Medicaid Accountable Care Organization

JAMA Pediatr 170:148-154. Children’s Hospitals and Clinics of Minnesota, Minneapolis, MN, USA IMPORTANCE: Little is known about the effect of pediatric accountable care organizations (ACOs) […]

Factors associated with acute care use among nursing home residents dying of cancer: a population-based study

Int J Palliat Nurs 21:349-356. McMaster University, Hamilton, ON, Canada BACKGROUND: Little is known about residents of long-term care (LTC) facilities who die of cancer. […]

Predictors of opioid-related death during methadone therapy

J Subst Abuse Treat 57:30-35. University of Toronto, ON, Canada; Institute for Clinical Evaluative Sciences, Toronto, ON, Canada; St. Michael’s Hospital, Toronto, ON, Canada; St. […]

The potential for community-based health information exchange systems to reduce hospital readmissions

J Am Med Inform Assoc 22:435-442. Weill Cornell Medical College, New York, NY, USA BACKGROUND: Hospital readmissions are common, costly, and offer opportunities for utilization […]

Fifty years of pediatric asthma in developed countries: how reliable are the basic data sources?

Pediatr Pulmonol 47:211-219. British Columbia’s Children’s Hospital, Vancouver, BC, Canada Given the difficulties in diagnosing, or even defining, asthma in children, claims of a pediatric […]

Application of the Ambulatory Care Groups in the primary care of a European national health care system: does it work?

Med Care 37:238-248. Astrabudúa Health Center, Osakidetza/Basque Health Service, Bizkaia, Spain BACKGROUND: Ambulatory Care Groups (ACGs), a US case mix system that uses the patient […]

Quality assessment: is the focus on providers or on patients?

Int J Qual Health Care 8:231-241. Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, USA Most studies of ambulatory care quality are based on chart […]

Biphasic fracture risk in diabetes: a population-based study

Bone 40:1595-1601. Department of Medicine, University of Manitoba, Winnipeg, MB, Canada Diabetes is associated with increased fracture rates but the effect size, time course and […]

The comorbidity burden of the treated asthma patient population in British Columbia

Chronic Dis Can 30:46-55. University of British Columbia, Faculty of Pharmaceutical Sciences, Vancouver, BC, Canada To date there has been little investigation of the prevalence […]

Nonparticipation in a population-based trial to increase colorectal cancer screening

Am J Prev Med 42:390-397. Group Health Permanente, University of Washington Medical School, Seattle, WA, USA BACKGROUND: Many trials have tested different strategies to increase […]

Institutionalization following incident non-traumatic fractures in community-dwelling men and women

Osteoporos Int 23:2381-2386. Division of General Internal Medicine, McGill University Health Center, Montreal, QC, Canada Institutionalization after hip fracture occurs in at least 30% of […]

Methods for analyzing health care utilization and costs

Annu Rev Public Health 20:125-144. Department of Biostatistics, University of Washington, Seattle, WA, USA Important questions about health care are often addressed by studying health […]

Mortality rates after incident non-traumatic fractures in older men and women.

Osteoporos Int 22:2439-2448. Division of General Internal Medicine, McGill University Health Center, Montreal, QC, Canada Non-traumatic fractures at typical osteoporotic sites are associated with increased […]

Comorbidity patterns in patients with chronic diseases in general practice

PLoS One 7:e32141. Multiprofessional Education Unit for Family and Community Care (Southwest), Madrid, Spain INTRODUCTION: Healthcare management is oriented toward single diseases, yet multimorbidity is […]

Primary care physician compensation method in medical groups: does it influence the use and cost of health services for enrollees in managed care organizations?

JAMA 279:853-858. Department of Health Services, University of Washington, Seattle, WA, USA CONTEXT: Growth of at-risk managed care contracts between health plans and medical groups […]

Health-based payment and computerized patient record systems

Eff Clin Pract 1:66-72. Center for Health Research, Kaiser Permanente, Northwest Division, Portland, OR, USA. Health care information technology is changing rapidly and dramatically. A […]

Morbidity and older persons’ perceptions of the quality of their primary care

J Am Geriatr Soc 54:330-334. Department of Health Policy and Management, Bloomberg School of Public Health, School of Medicine, Johns Hopkins University, Baltimore, MD, USA […]

Primary care physicians’ experiences with case finding for practice-based care management

Am J Manag Care 18:e155-161. Department of General Practice and Health Services Research, University Hospital Heidelberg, Heidelberg, Germany. OBJECTIVES: The identification of patients most likely […]

A population-based analysis of the clinical course of 10,304 patients with acute cholecystitis, discharged without cholecystectomy

J Trauma Acute Care Surg 74:26-30; discussion 30-1. Li Ka Shing Knowledge Institute, St Michael’s Hospital; and Institute for Clinical Evaluative Science, Toronto, ON, Canada […]

Self-referral in point-of-service health plans

JAMA 285:2223-2231. Department of Health Policy and Management, Johns Hopkins School of Hygiene and Public Health, Baltimore, MD, USA CONTEXT: Most health maintenance organizations offer […]