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Insurance coverage and subsequent utilization of complementary and alternative medicine providers

Am J Manag Care 12:397-404. Department of Health Services, School of Public Health and Community Medicine, University of Washington, Seattle, WA, USA BACKGROUND: Since 1996, […]

Multimorbidity, polypharmacy, referrals, and adverse drug events: are we doing things well?

Br J Gen Pract 62:e821. Aragón Health Sciences Institute (IACS), Miguel Servet University Hospital, University of Zaragoza, Spain BACKGROUND: The consequences of multimorbidity include polypharmacy […]

Costs and associated factors with optimal and suboptimal responses to the treatment of major depressive disorder

Aten Primaria 44:667-675. Published in Spanish. Dirección de Planificación, Badalona Serveis Assistencials, Barcelona, Spain OBJECTIVE: To evaluate the compliance, persistence and costs of the treatment […]

Factors associated with hospitalisations for ambulatory care-sensitive conditions among persons with an intellectual disability: a publicly insured population perspective

J Intellect Disabil Res 57:226-239. Dual Diagnosis Program, Centre for Addiction and Mental Health, Toronto, ON, Canada BACKGROUND: Hospitalisations for ambulatory care-sensitive (ACS) conditions are […]

Cardiovascular safety of inhaled long-acting bronchodilators in individuals with chronic obstructive pulmonary disease

JAMA Intern Med 173:1175-1185. Institute for Clinical Evaluative Sciences, Toronto, ON, Canada; Department of Medicine, Sunnybrook Health Sciences Centre, Toronto, ON, Canada; Child Health Evaluative […]

The disconnect between better quality of glucocorticoid-induced osteoporosis preventive care and better outcomes: a population-based cohort study

J Rheumatol 40:1736-1741. University of Alberta, Edmonton, AB, Canada; University of Manitoba, Winnipeg, MB; McGill University, Montreal, QC, Canada OBJECTIVE: The quality of glucocorticoid-induced osteoporosis […]

Glucagonlike peptide 1-based therapies and risk of hospitalization for acute pancreatitis in type 2 diabetes mellitus: a population-based matched case-control study

JAMA Intern Med 173:534-539. Department of Medicine, Johns Hopkins University Schools of Medicine and Public Health, Baltimore, MD, USA IMPORTANCE: Acute pancreatitis has significant morbidity […]

The association between obesity and outpatient visits for acute respiratory infections in Ontario, Canada

Int J Obes 38:113-119. Institute for Clinical Evaluative Sciences, Toronto, ON, Canada; Public Health Ontario, Toronto, ON, Canada; University of Toronto, Toronto, ON, Canada OBJECTIVE: […]

Effects of impairment in activities of daily living on predicting mortality following hip fracture surgery in studies using administrative healthcare databases

BMC Geriatr 14:9. Queen’s University, Kingston, ON, Canada BACKGROUND: Impairment in activities of daily living (ADL) is an important predictor of outcomes although many administrative […]

Variation in inpatient hospital prices and outpatient service quantities drive geographic differences in private spending in Texas

Health Serv Res. University of Texas School of Public Health, Houston, TX, USA OBJECTIVE: To measure the contribution of market-level prices, utilization, and health risk […]

Predictive validity of tools used to assess the risk of unplanned admissions: a rapid review of the evidence

York, UK: University of York. University of York, York, UK CRD has developed an evidence briefing and support service tailored to the needs of commissioners […]

Physician integrated network: a second look

Winnipeg, MB, Canada: Manitoba Centre for Health Policy. Manitoba Centre for Health Policy, Winnipeg, MB, Canada This is the second report from Manitoba Centre for […]

Putting your faith in data

Commissioning Success :34-36. No abstract. Article a PDF.

Does surgical setting or wait-time incentive improve return to work following knee surgery among injured workers?

Final report to WorkSafeBC. Vancouver, BC, Canada: University of British Columbia. University of British Columbia, Vancouver, BC, Canada; University Health, Toronto, ON, Canada; University of […]

The faces of Medicaid: the complexities of caring for people with chronic illnesses and disabilities

Hamilton, NJ, USA: Center for Health Care Strategies. Center for Health Care Strategies, Hamilton, NJ, USA A complex question has persisted in our minds since […]

Employer purchasing coalitions and Medicaid: experiences with risk adjustment

New York, NY, USA: Commonwealth Fund. Commonwealth Fund, New York, NY, USA Choice among health plans increases patient satisfaction with care and enables families to […]

Clinical and economic features of categories of patients in defined populations

Stockholm, Sweden: Karolinska Institute (doctoral dissertation). Department of Clinical Services, Center for Family and Community Medicine, Karolinska Institute, Stockholm, Sweden This thesis addresses the use […]

Use predictive modeling to improve profitability under cap

National Health Information LLC. Capitation Rates and Data 9:61-65. National Health Information LLC, Atlanta, GA, USA Health plans and capitated provider organizations live or die […]

Health-based risk assessment: risk-adjusted payments and beyond

Washington, DC, USA: AcademyHealth. AcademyHealth, Washington, DC, USA A number of payers across the country, including Medicaid managed care programs, the Medicare+Choice program, some state […]

Cost benefit analysis of pharmaceutical care in a Medicaid population – from a budgetary perspective

J Managed Care Pharm 4:303-308. Nova Southeastern University, Ft. Lauderdale, FL, USA The objective was to evaluate the economic impact of Medicaid pharmaceutical care services […]

Comparing the value of three main diagnostic-based risk-adjustment systems (DBRAS)

Ottawa, ON, Canada: Canadian Health Services Research Foundation. Canadian Health Services Research Foundation, Ottawa, ON, Canada Diagnostic-Based Risk-Adjustment Systems (DBRAS) are now widely used in […]

Using pharmacy information in a decision support system to improve efficient delivery of primary health care

A study focusing on the Swedish national drug register. BMC Health Serv Res 0:A6. Ensolution, Stockholm, Sweden INTRODUCTION: The aim of the project was to […]

Utilización de los grupos clínicos ajustados en un centro de atención primaria español: estudio retrospectivo de base poblacional

Rev Panam Salud Publica 27:49-55. Published in Spanish. Dirección de Planificación, Badalona Serveis Assistencials, S.A., Barcelona, Spain OBJETIVOS. Evaluar los resultados de la aplicación del […]

Disparities in antipsychotic medication use

Vancouver, BC, Canada: University of British Columbia (masters thesis). University of British Columbia, Vancouver, BC, Canada OBJECTIVES: To examine ethnic and income-related disparities in the […]

Pilot projects carried out in Lithuania and Latvia: quality indicators for high quality PHC performance

ImPrim Report #3. Karlskrona, Sweden: ImPrim. Klaipeda University, Klaipeda, Lithuania Quality improvement of primary health care is the topic requiring attention from all stakeholders  throughout […]

Who is in our hospitals … and why?

Winnipeg, MB, Canada: Manitoba Centre for Health Policy. Manitoba Centre for Health Policy, Winnipeg, MB, Canada This report provides a snapshot of patients in acute […]

Kronik: Datafangst fra nyt system kan anvendes både administrativt og sundhedspolitisk

Ugeskrift for Laeger 176:380-381. Published in Danish. Syddansk University, Odense, Denmark

ACG System Predictive Models Overview

This document provides a high-level overview of how the predictive models within the Johns Hopkins Adjusted Clinical Groups® (ACG) System are designed and the factors […]

Morbidity Burden in Persons with Multiple Chronic Conditions

Morbidity Burden in persons with Multiple Chronic Conditions and Identification of inequitable resource use in Israel Dr. Efrat Shadmi Faculty of Social Welfare and Health […]

Application of ACGs to Medical Claim Records in Japan

Tokyo Medical and Dental University Application of the ACG System to Medical Claim Records in Japan Koichi Kawabuchi

Tuesday-Utilization-Chang

Johns Hopkins ACG System Consistent High Users: Characteristics and Identification Hsien-Yen Chang, PhD. Research Associate

Tuesday-Keynote III-Weiner

Johns Hopkins ACG System Risk Adjustment and Predictive Modeling in Health Reform Jonathan Weiner

Monday-Care Coordination I-Pollack

Johns Hopkins ACG System Innovations in Measuring and Managing Care Coordination Craig Pollack, MD, MHS

The future of integrated care in the NHS

The King’s Fund The Future of Integrated Care in the NHS Professor Chris Ham Chief Executive  

Monday(P1)-A New Day in Population Health Management: Innovations in Risk Adjustment and Predictive Modeling-Weiner

A New Day in Population Health Management: Innovations in Risk Adjustment and Predictive Modeling Welcome and Opening Remarks  Jonathan P. Weiner, DRPH Professor and CEO […]

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Reducing Readmissions

Is your hospital or health system interested in reducing readmissions? Turning data points into actionable insights is key to understanding and addressing the drivers of readmission rates. Learn more in this step-by-step instructional video.

Rehabilitation of Older Adults with Dementia After Hip Fracture

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

Risk of rhabdomyolysis from 5‐α reductase inhibitors

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

Respiratory health service utilization of children with neuromuscular disease

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Post-discharge Home Care Services Use, Long-Term Care Placement, and Survival in Older Adults with Major Trauma: a Population-Based Cohort Study from Ontario, Canada

Abstract Background There are few studies describing health services use and longer-term survival in older adults with major injuries. Our objectives were to characterize the […]

Concurrent Emergency Department Use by a New Mother With a Disability and Her Newborn

ABSTRACT OBJECTIVES To assess the risk of concurrent emergency department use (Co-ED) among women with a preexisting disability and their infants. METHODS This population-based cohort […]

Healthcare utilization among survivors of childhood and adolescent cancer: a population-based study

Abstract Introduction Survivors of childhood and adolescent cancers are at increased risk for late effects. Few studies have investigated if this translates into increased healthcare […]

Longitudinal population-based analysis of diabetic retinopathy screening rates for newly diagnosed diabetes in Ontario

Abstract Purpose To evaluate longitudinal trends and determinants of diabetic retinopathy (DR) screening uptake over 10 years among adults with newly diagnosed diabetes in Ontario, […]

Health Care Use and Outcomes Among Participants Enrolled in the Mayo Clinic Primary Care House Call Program: A Case-Control Study

Abstract Introduction/Objectives: House call programs provide care for homebound patients. We conducted a case-control study to compare hospitalization and/or emergency department (ED) use by patients […]

Assessing the impact of delivery method on severe maternal morbidity among individuals with inflammatory bowel disease: a population-based study

Abstract Background & Aims Individuals with inflammatory bowel disease (IBD) may have worse obstetrical outcomes than those without IBD. We assessed the odds of severe […]

Effectiveness of telehealth versus in-person care during the COVID-19 pandemic: a systematic review

Abstract In this systematic review, we compared the effectiveness of telehealth with in-person care during the pandemic using PubMed, CINAHL, PsycINFO, and the Cochrane Central […]

Maternal Immigrant Status and Mortality in Children With Congenital Heart Disease: A Population-Based Cohort Study

ABSTRACT Background This study examined the association between maternal immigrant status and survival of children with congenital heart diseases (CHD) in Ontario, Canada. Methods A […]

Evaluating an insurer-based health coaching program: Impact of program engagement on healthcare utilization and weight loss

Abstract Insurers and employers are increasingly offering lifestyle and weight-loss coaching programs; however, few evaluations have examined their effectiveness. Our objectives were to determine whether […]

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Population Health Profiling

This webinar will explore how the ACG System can – and is – being used to support commissioners and those responsible for the management of […]

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Risk adjusted resource allocation in Sweden

Presented by:Andreas Johansson, M.Sc., Founder of Ensolution

Comparison of health care needs of child family members of adults with alcohol or drug dependence versus adults with asthma or diabetes

J Dev Behav Pediatr 35:282-291. Division of Research, Kaiser Permanente Northern California, Oakland, CA, USA OBJECTIVE: To compare the health problems, preventive care utilization, and […]

Prevalence of depression in adults with type 2 diabetes in the Basque Country: relationship with glycaemic control and health care costs

BMC Public Health 14:769. Basque Institute for Healthcare Innovation, Barakaldo, Spain BACKGROUND: The aim of the study was to estimate the prevalence of depression in […]

Data resource profile: Pathways to Health and Social Equity for Children (PATHS Equity for Children)

Int J Epidemiol 43:1438-1449. Manitoba Centre for Health Policy, Winnipeg, MB, Canada The PATHS Data Resource is a unique database comprising data that follow individuals […]

Incidence of severe hypoglycaemic episodes in patients with type 2 diabetes in the Basque country: impact on healthcare costs

BMC Health Serv Res 15:207. Basque Institute for Healthcare Innovation, Barakaldo, Spain; Osakidetza, Basque Health Service, Erandio, Spain; University of Deusto, Bilbao, Spain BACKGROUND: Hypoglycaemia […]

Variability in potentially preventable hospitalisations: an observational study of clinical practice patterns of general practitioners and care outcomes in the Basque Country (Spain)

BMJ Open 5:e007360. Osakidetza Basque Health Service, Erandio, Bizkaia, Spain; University of Deusto, Bilbao, Spain OBJECTIVES: To explain the variability in the frequency of potentially […]

Outcomes among patients discharged from the emergency department with a diagnosis of peripheral vertigo

Ann Neurol 79:32-41. University of Toronto, Toronto, ON, Canada; Sunnybrook Health Sciences Centre, Toronot, ON, Canada; Institute of Health Policy, Management and Evaluation at the […]

Evaluation of an innovative program to improve outcomes among military beneficiaries with diabetes

Nurs Econ 33:271-280. University of Texas at Tyler, Tyler, TX, USA; Texas A&M University Health Science Center, Bryan, TX, USA Patients with Type 2 Diabetes […]

Health administrative data can be used to define a shared care typology for people with HIV

J Clin Epidemiol 68:1301-1311. Bruyère Research Institute, Ottawa, ON, Canada; University of Ottawa, Ottawa, ON, Canada; Institute for Clinical Evaluative Sciences, Ottawa, ON, Canada; Ottawa […]

Trends in relative survival in patients with a diagnosis of hepatocellular carcinoma in Ontario: a population-based retrospective cohort study

CMAJ Open 3:E208-E216. University of Toronto, Toronto, ON, Canada; Ontario Institute for Cancer Research/Cancer Care Ontario, Toronto, ON, Canada; Institute for Clinical Evaluative Sciences, Toronto, […]

Prevalence and costs of chronicity and multimorbidity in the population covered by the Basque public telecare service

An Sist Sanit Navar 36:429-339, Published in Spanish. Centro de Salud Astrabudua, Erandio, Spain BACKGROUND: The public telecare service in the Basque Autonomous Community (betiON) […]

Medication, diagnostic, and cost information as predictors of high-risk patients in need of care management

Am J Manag Care 15:41-48. Department of Pediatrics, Children’s Hospital of Philadelphia, Philadelphia, PA, USA OBJECTIVE: To contrast the advantages and limitations of using medication, […]

Preventive screening of women who use complementary and alternative medicine providers

J Womens Health 18:1133-1143. Department of Health Services, School of Public Health and Community Medicine, University of Washington, Seattle, WA, USA BACKGROUND: Many women use […]

Explaining prescription drug use and expenditures using the Adjusted Clinical Groups case-mix system in the population of British Columbia, Canada

Med Care 48:402-408. Centre for Health Services and Policy Research, University of British Columbia, School of Population and Public Health, Vancouver, BC, Canada BACKGROUND: Given […]

Methods of reducing the financial risk of physicians under capitation

Arch Fam Med 8:149-155. Johns Hopkins Center for Hospital Finance and Management, Baltimore, MD, USA. In today’s rapidly changing medical marketplace, managed care plans are […]

Use of well-child visits in high-deductible health plans

Am J Manag Care 16:833-840. Center for Child Health Care Studies, Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, […]

Risk adjustment for people with chronic conditions in private sector health plans

Med Decis Making 23:397-405. The MEDSTAT Group, Inc., Washington, DC, USA BACKGROUND: Although the problem of adverse selection into more generous health insurance plans has […]

Ambulatory care practice variation within a Medicaid program

Health Serv Res 30:751-770. Johns Hopkins University, School of Public Health, Department of Health Policy and Management, Baltimore, MD, USA STUDY QUESTIONS: What is the […]

Tamoxifen use and osteoporotic fracture risk: a population-based analysis

J Clin Oncol 26:5227-5232. CancerCare Manitoba, Winnipeg, MB, Canada PURPOSE: Although tamoxifen has been shown to increase bone mineral density in clinical trials, it is […]

Patient race/ethnicity and shared medical record use among diabetes patients

Med Care 50:434-440. Center for Vulnerable Populations, University of California, San Francisco, CA, USA BACKGROUND: Previous studies have documented racial/ethnic differences in patients’ use of […]

Distribution of primary care expenditure according to sex and age group: a retrospective analysis

Aten Primaria 44:145-152. Published in Spanish. Centre d’Atenció Integral Dos de Maig, Consorci Sanitari Integral, Barcelona, Spain; Dirección de Planificación y Desarrollo Organizativo, Badalona Serveis […]

Ambulatory encounter systems: implications for payment and quality

J Ambul Care Manage 16:33-49. Many key decision makers are looking to AESs solely for purposes of payment. This approach is unfortunate because many systems […]

Identification of pharmacy cost outliers in primary care

Aten Primaria 41:453-459. Published in Spanish. Instituto Aragonés de Ciencias de la Salud, Zaragoza, España OBJECTIVE: To identify pharmacy cost outlier patients in Primary Care, […]

Impact of deductibles on initiation and continuation of psychotherapy for treatment of depression

Health Serv Res 47:1561-1579. Group Health Research Institute and University of Washington, Seattle, WA, USA OBJECTIVE: To estimate the impact of deductibles on the initiation […]

Ambulatory care sensitive hospitalizations and emergency visits: experiences of Medicaid patients using federally qualified health centers

Med Care 39:551-561. MDS Associates, Wheaton, MD, USA BACKGROUND: Federally Qualified Health Centers (FQHCs) serve as regular sources of preventive and primary care for low-income […]

Health-risk-assessment tools used to predict costs in defined populations

J Healthc Inf Manag 14:31-57. Vanderbilt University Medical Center, Nashville, TN, USA With the Balanced Budget Act of 1997 mandating that the Health Care Financing […]

Comparison of risk adjusters for Medicaid-enrolled children with and without chronic health conditions

Ambul Pediatr 1:217-224. Department of Health Policy and Management, School of Hygiene and Public Health, Johns Hopkins University, Baltimore, MD, USA OBJECTIVE: Several capitation payment […]

Retrospective application of Adjusted Clinical Groups (ACGs) at a primary care centre

Aten Primaria 37:439-445. Published in Spanish. Dirección de Planificación, Badalona Servicios Asistenciales S.A. Badalona, Barcelona, España OBJECTIVE: To evaluate retrospectively the application of adjusted clinical […]

Using health-related quality of life assessments to evaluate care support within Medicaid

Care Manag J 9:42-50. Center for Health Research, Kaiser Permanente, Portland, OR, USA CareOregon, an Oregon-based not-for-profit Medicaid health plan, successfully piloted a “CareSupport” model […]