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Risk-stratification methods for identifying patients for care coordination

Am J Manag Care 19:725-732. Mayo Clinic, Rochester, MN, USA BACKGROUND: Care coordination is a key component of the patient-centered medical home. However, the mechanism […]

Predictors of short-term postoperative survival after elective colectomy in colon cancer patients >/= 80 years of age

Ann Surg Oncol 20:1427-1435. Department of Surgery, UW Madison School of Medicine and Public Health, Madison, Wisconsin, USA BACKGROUND: Individuals ≥ 80 years of age […]

Movement disorders in elderly users of risperidone and first generation antipsychotic agents: a Canadian population-based study

PLoS One 8:e64217. Faculty of Pharmacy, University of Manitoba, Winnipeg, MB, Canada BACKGROUND: Despite concerns over the potential for severe adverse events, antipsychotic medications remain […]

Patient and Physician Factors Associated With Pulmonary Function Testing for COPD: A Population Study

Chest 145:272-281. Institute for Clinical Evaluative Sciences; Sunnybrook Research Institute; Sunnybrook Health Sciences Centre; University of Toronto, Toronto, ON, Canada BACKGROUND: The diagnosis of COPD […]

Identifying controlled substance patterns of utilization requiring evaluation using administrative claims data

Am J Manag Care 10:783-790. HSI Network LLC, USA OBJECTIVES: To develop a systems approach to identify, for further evaluation, patients with potential controlled substance […]

The meaningful use of electronic health records and health care quality

Am J Med Qual 30:512-519. Weill Cornell Medical College, New York, NY, USA The federal government is investing approximately $30 billion in incentives for adoption […]

Copayment level and drug switching: findings for type 2 diabetes

Am J Pharm Benefits 2:412-420. University of Hawaii at Manoa, Honolulu, HI, USA OBJECTIVE: To assess the relationship between copayment level and drug switching among […]

Does increased medication use among seniors increase risk of hospitalization and emergency department visits?

Working Paper 150004. Toronto, ON, Canada: Canadian Centre for Health Economics. Canadian Centre for Health Economics, Toronto, ON, Canada Objective: to examine the extent of […]

Diagnosis and disruption: understanding guideline-consistent dementia care and patterns of transition experienced by individuals with dementia

Vancouver, BC, Canada: University of British Columbia (doctoral dissertation). University of British Columbia, Vancouver, BC, Canada Introduction: Early detection and management, as outlined in dementia […]

CareOregon: transforming the role of a Medicaid health plan from payer to partner

New York, NY, USA: Commonwealth Fund. Commonwealth Fund, New York, NY, USA CareOregon, a Portland, Oregon-based nonprofit Medicaid health plan, developed two innovative programs to […]

The knowledge of morbidity in primary care as an aid in the planning and management of the services

Semergen doi:10.1016/j.semerg.2009.12.003. Published in Spanish. Servicio Canario de la Salud, Santa Cruzde Tenerife, Spain The analysis of the morbidity and management of its knowledge is […]

Allocating funds for healthcare in Manitoba regional health authorities: a first step – population-based funding

Winnipeg, MB, Canada: Manitoba Centre for Health Policy. Manitoba Centre for Health Policy, Dept. of Community Health Sciences, Faculty of Medicine, University of Manitoba, Winnipeg, […]

Managed care holds down costs, doesn’t hurt quality

Minneapolis Star Tribune, January 3:A13. No abstract

Risk adjustment lexicon

Reporting Framework Subcommittee of the Steering Committee of the Minnesota ACG Users Group. Revised by Chad Abrams, Terry Bernhardt, Steven Foldes, Jason Wiley, May 17, […]

Quality of care for Medicaid and privately insured children in a commercial insurance plan

Richmond, VA, USA: Virginia Commonwealth University (doctoral dissertation). Virginia Commonwealth University, Richmond, VA, USA The central thesis of this study is that exposure to the […]

Risk adjustment in competitive health plan markets

In: Culyer AJ, Newhouse JP, ed. Handbook of Health Economics, Volume 1. Amsterdam, Netherlands: Elsevier Science B. V.:755-845. Erasmus University, Rotterdam, Netherlands; Boston University, Boston, […]

Equity in health, health care services use and health care financing in British Columbia, 1992 and 2002

Vancouver, BC, Canada: University of British Columbia (doctoral dissertation). University of British Columbia, Vancouver, BC, Canada The objectives of this thesis are to identify equity […]

Work limitations and their relationship with morbidity burden in employed persons with diabetes

Baltimore, MD, USA: Johns Hopkins University (doctoral dissertation). Johns Hopkins University, Baltimore, MD, USA BACKGROUND. Work limitations are functional limitations within the work context resulting […]

The application of Johns Hopkins Adjusted Clinical Group Case-mix System in AFMS

In: Cato W, Roberts WC, ed. Proceedings of the 2011 AFMS Medical Research Symposium, Volume 4. Healthcare Informatics Track. August 2-4, 2011, National Harbor, MD, […]

Morbi-mortality and use of recourses after acute coronary syndrome in a Spanish population

Revista Clinica Espanola 211:560-571. Directorate of Planning, Badalona Serveis Assistencials SA, Badalona, Spain Morbi-mortality and use of recourses after acute coronary syndrome in a Spanish […]

A population-based study of healthcare resource utilization by metastatic gastric cancer patients in Ontario

Kingston, ON, Canada: Queens University (masters theseis). Queens University, Kingston, ON, Canada BACKGROUND: Gastric cancer is the fourth most common cancer in the world. Non-curative, […]

Association between use of a specialized diagnostic assessment unit and the diagnostic interval in Ontario breast cancer patients

Kingston, ON, Canada: Queen’s University (masters thesis). Queen’s University, Kingston, ON, Canada BACKGROUND: The amount of time that it takes to get a breast cancer […]

Comorbidity and healthcare expenditure in women with osteoporosis living in the Basque Country (Spain)

J Osteoporosis Basque Institute for Healthcare Innovation, Barakaldo, Spain BACKGROUND: The aim of the study was to estimate the prevalence of depression in the population […]

The Value of Patient Identification

Johns Hopkins Bloomberg School of Public Health The Value of Patient Identification Karen Kinder, PhD., MBA

One way of measuring morbidity of HA Patients

Hospital Authority One Way of Measuring Morbidity of HA Patients: from Research to Lessons Learnt Dr. Deacons Yeung Chief Manager

ACG 101

DST Health Solutions ACG 10 Lisa Kabasakalian

Applying the ACG System to support case management for the population of Eastern Cheshire

Integral Health Solutions Applying ACGs to care co-ordination, planning and commissioning Bernadette Bailey, Transformation Programme Manager, Eastern Cheshire CCG Jayne Molyneux, Care Co-ordination Advisor, Integral […]

Monday(C1)-Concurrent Resource Use and All Age Modeling – Abrams

Concurrent Resource Use and All Age Modeling – Chad Abrams

Monday(P5)-Understanding Transitions in Morbidity Burden: an Exploratory Analysis

David Linz, MA Robert Reid, MD, PhD  Paul Fishman, PhD 

A Health Plan and the ACG System

At an event celebrating the ACG System receiving the 2015 Health Services Research (HSR) Award from AcademyHealth, Patricia M. C. Brown, Esq., President, Johns Hopkins […]

Data Visualization and Patient Identification – Military

The Defense Health Agency (DHA) supports the delivery of integrated, affordable, and high-quality health services to Military Health System (MHS) beneficiaries and is responsible for […]

Outcomes of patients with chronic obstructive pulmonary disease diagnosed with or without pulmonary function testing

Background: A small number of people with chronic obstructive pulmonary disease (COPD) receive pulmonary function testing around the time of diagnosis. Because omitting testing increases […]

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 […]

A Canadian Population-Based Cohort to the Study Cost and Burden of Surgically Resected Hidradenitis Suppurativa

Abstract Background: Hidradenitis suppurativa (HS) is a chronic debilitating disease with long-lasting comorbidities that impose direct and indirect costs on the health care system. However, […]

Medicaid trends in prescription opioid and non-opioid use by HIV status

Abstract   Background Pain is more common among people living with HIV (PLWH) than their counterparts; however, it is unclear whether analgesic use differs by […]

Supporting general practice to make timely decisions for better health care: a population health approach

Abstract Primary Health Networks (PHNs) are tasked to enhance the efficiency and effectiveness of general practice. Gold Coast Primary Health Network (GCPHN) has been collecting […]

Is Post-discharge Rehabilitation Timing Associated with 90-Day Readmission in Primary Total Joint Arthroplasty?

Abstract Background Physical therapy (PT) is an accepted standard of care after total joint arthroplasty (TJA) and essential to maximizing joint functionality and minimizing complications […]

Prediction of 30-day pediatric unplanned hospitalizations using the Johns Hopkins Adjusted Clinical Groups risk adjustment system

Abstract Background The Johns Hopkins ACG System is widely used to predict patient healthcare service use and costs. Most applications have focused on adult populations. […]

Impact of comprehensive care on health care use among a cohort of marginalized people living with hepatitis C in Toronto, Canada

Abstract Background The majority of new hepatitis C (HCV) cases occur among people who inject drugs. In recent years, multidisciplinary models of HCV treatment have […]

Association of Follow-Up Care With Long-Term Death and Subsequent Hospitalization in Patients With Atrial Fibrillation Who Receive Emergency Care in the Province of Ontario

Abstract Background Currently, 11% of patients seen in the emergency department for atrial fibrillation die within 1 year of the visit. Our objective was to […]

Measuring multimorbidity beyond counting diseases: systematic review of community and population studies and guide to index choice

Abstract Objectives To identify and summarise existing indices for measuring multimorbidity beyond disease counts, to establish which indices include mental health comorbidities or outcomes, and […]

Health characteristics of reproductive-aged autistic women in Ontario: A population-based, cross-sectional study

Abstract While an increasing number of girls and women are being identified with autism, we know little about the health of reproductive-aged autistic women. Our […]

The effect of frailty on postoperative readmissions, morbidity, and mortality in endometrial Cancer surgery

Abstract Objectives To determine the impact of frailty on postoperative readmission, morbidity, and mortality among patients undergoing surgery for endometrial cancer. Methods Patients with endometrial […]

Association between mental health comorbidity and health outcomes in type 2 diabetes mellitus patients

Abstract Background Type 2 diabetes mellitus (T2D) is often accompanied by chronic diseases, including mental health problems. We aimed at studying mental health comorbidity prevalence […]

Analysis of modifiable and nonmodifiable risk factors in patients undergoing pituitary surgery

Abstract OBJECTIVE Pituitary adenomas (PAs) are among the most common intracranial tumors. Understanding the clinical effects of various modifiable risk factors (MRFs) and nonmodifiable risk […]

Health care service use and costs for a cohort of high-needs elderly diabetic patients

Abstract Aims To describe the impact of diabetes comorbidities on the health care services use and costs of a cohort of elderly patients with diabetes […]

Management and outcomes of patients with chronic obstructive lung disease and lung cancer in a public healthcare system

Abstract Hypothesis There is limited data on the care and outcomes of individuals with both chronic obstructive pulmonary disease (COPD) and lung cancer, particularly in […]

Guideline interval: A new time interval in the diagnostic pathway for symptomatic cancer

Abstract Background: A standard measure of the cancer diagnostic pathway, diagnostic interval, is the time from “first presentation of cancer” to diagnosis. Cancer presentation may be […]

Impact of Frailty on Clinical and Financial Outcomes Following Minor Lower Extremity Amputation: A Nationwide Analysis

Abstract Objective Frailty has been shown to portend worse outcomes in surgical patients. Our goal was to identify the impact of frailty on outcomes and […]

The clinical impact of frailty on the postoperative outcomes of patients undergoing gastrectomy for gastric cancer: a propensity-score matched database study

Abstract Background Frailty aggregates a composite of geriatric and elderly features that is classified into a singular syndrome; literature thus far has proven its influence […]

Outcomes of SARS-CoV-2 infection in cancer versus non-cancer-patients: A population-based study in northeastern Italy

Abstract Introduction This study assesses the risk of infection and clinical outcomes in a large consecutive population of cancer and non-cancer patients tested for SARS-CoV-2 […]

Survival effects of time to surgery for Stage I lung cancer: A population-based study

Abstract Objectives To examine the impact of time to surgery (TTS) on survival among patients with stage I non-small cell lung cancer (NSCLC). Methods All […]

Development and validation of predictive models for unplanned hospitalization in the Basque Country: analyzing the variability of non-deterministic algorithms

Abstract Background The progressive ageing in developed countries entails an increase in multimorbidity. Population-wide predictive models for adverse health outcomes are crucial to address these […]

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

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

Case Finding and Population Profiling

This webinar focuses on a project undertaken in Slough Clinical Commissioning Group where information from the ACG System was used to profile the population of […]

Leveraging Prescription Data to Derive Future Costs and Predictors Regarding Opioid Abuse Patients

Presented by: David Bodycombe, ScD, MSc

Director ACG System Research

This Webinar describes his study, which created and assessed three measures of high-risk opioid use, presents results supporting the utility of these measures, and describes how the resulting measures are being deployed within the ACG System. Learn More.

Risk prediction models to predict emergency hospital admission in community-dwelling adults: a systematic review

Med Care 52:751-756. Centre for Primary Care Research, Royal College of Surgeons in Ireland, Dublin, Ireland BACKGROUND: Risk prediction models have been developed to identify […]

Frequent attenders in general practice and immigrant status in Norway: A nationwide cross-sectional study

Scand J Prim Health Care 32:232-240. Department of Global Public Health and Primary Care, University of Bergen, Norway OBJECTIVE: To compare the likelihood of being […]

Drugs prescribed by general practitioners according to age, gender and socioeconomic status after adjustment for multimorbidity level

BMC Fam Pract 15:183. Department of Clinical Sciences in Malmö, Center for Primary Health Care Research, Lund University, Malmö, Sweden BACKGROUND: Age, gender and socioeconomic […]

Direct medical costs attributable to venous thromboembolism among persons hospitalized for major operation: a population-based longitudinal study

Surgery 157:423-451. Mayo Clinic, Rochester, MN, USA; K Long Health Economics Consulting LLC, St. Paul, MN, USA BACKGROUND: We estimated medical costs attributable to venous […]

Preventive counseling services during primary care visits: a comparison of health centers versus other physician offices

J Health Care Poor Underserved 26:519-535. Johns Hopkins University, Baltimore, MD, USA We compared preventive counseling services provided by health centers versus other physician offices. […]

A comprehensive assessment of family physician gender and quality of care: a cross-sectional analysis in Ontario, Canada

Med Care 54:277-286. University of Ottawa, Ottawa, ON, Canada; Institute of Clinical Evaluative Sciences, Ottawa, ON, Canada; Queen’s University, Kingston, ON, Canada; Monash University, Clayton, […]

Prescription stimulant use and hospitalization for psychosis or mania: a population-based study

J Clin Psychopharmacol 35:667-671. Institute for Clinical Evaluative Sciences, Toronto, ON, Canada; University of Toronto, Toronto, ON, Canada; St Michael’s Hospital, Toronto, ON, Canada Small […]

Risk of cardiovascular events and mortality among a population-based cohort of immigrants and long-term residents with diabetes: Are all immigrants healthier and if so, for how long?

Am Heart J 170:123-132. University Health Network, Toronto, ON, Canada; Mount Sinai Hospital, Toronto, ON, Canada; Institute for Clinical Evaluative Sciences, Toronto, ON, Canada; University […]

Pain among older adults from a gender perspective: findings from the Swedish National Study on Aging and Care (SNAC-Blekinge)

Scand J Public Health Blekinge Institute of Technology, Karlskrona, Sweden; Lund University, Lund, Sweden; Linnaeus University, Växjö, Sweden BACKGROUND AND AIMS: Pain is common in […]

Ethnic disparities in care following acute coronary syndromes among Asian Americans and Pacific Islanders during the initial hospitalization

Cell Mol Biol 47:1209-1215. Hawaii Medical Service Association, Care Management, Honolulu, HI, USA Despite the fact that Asian Americans and Pacific Islanders are the fastest […]

Changes in health care costs over time following the cessation of intimate partner violence

J Gen Intern Med 25:920-925. Group Health Research Institute, Seattle, WA, USA BACKGROUND: Research has documented greater health care costs attributable to intimate partner violence […]

Universal health insurance and equity in primary care and specialist office visits: a population-based study

Ann Fam Med 7:396-405. Institute for Clinical Evaluative Sciences, Toronto, ON, Canada PURPOSE: Universal coverage of physician services should serve to reduce socioeconomic disparities in […]

Geographic variation in primary care visits in Iowa.

Health Serv Res 30:657-671. Graduate Program in Hospital and Health Administration, University of Iowa, Iowa City, IA, USA. OBJECTIVE: This study investigates the determinants of […]

Coding algorithms for defining comorbidities in ICD-9-CM and ICD-10 administrative data

Med Care 43:1130-1139. Department of Community Health Sciences, University of Calgary, Calgary, AB, Canada OBJECTIVES: Implementation of the International Statistical Classification of Disease and Related […]

Epidemiology and impact of multimorbidity in primary care: a retrospective cohort study

Br J Gen Pract 61:e12-e21. Department of Community Medicine, University of Bristol, Bristol, UK BACKGROUND: In developed countries, primary health care increasingly involves the care […]

Predictive modeling in practice: improving the participant identification process for care management programs using condition-specific cut points

Popul Health Manag 14:205-210. Research and Development Unit, Johns Hopkins HealthCare LLC, Glen Burnie, MD, USA The objective of this study was to optimize predictive […]

Fracture risk from psychotropic medications: a population-based analysis

J Clin Psychopharmacol 28:384-391. Department of Psychiatry, University of Manitoba, Winnipeg, MB, Canada BACKGROUND: Selective serotonin reuptake inhibitors (SSRIs), benzodiazepines, and antipsychotics have each been […]

Ankle fractures do not predict osteoporotic fractures in women with or without diabetes

Osteoporos Int 23:957-962. Faculty of Health Sciences, McMaster University, Hamilton, ON, Canada It is not clear whether ankle fractures predict future osteoporotic fractures in women, […]

The role of provider continuity in preventing hospitalizations

Arch Fam Med 7:352-357. Department of Family and Community Medicine, Christiana Care Health System, Wilmington, DE, USA OBJECTIVES: To examine the association between provider continuity […]

The effect of distance to primary care physician on health care utilization and disease burden

Health Care Manage Rev 32:22-29. University of Michigan Medical School, Ann Arbor, USA. BACKGROUND: The relationship of distance to care with total health care utilization […]

Case mix measures for ambulatory care

J Public Health Med 13:189-197. University of Newcastle upon Tyne, School of Health Care Sciences, Medical School, Newcastle, UK Resource management in Ambulatory Care is […]

Performance of diagnosis-based risk adjustment measures in a population of sick Australians

Aust N Z J Public Health 26:500-507. Faculty of Health Sciences, School of Public Health, La Trobe University, Victoria, Australia OBJECTIVE: Australia is beginning to […]

Morbidity profiles at three primary care clinics in Perlis, Malaysia

Med J Malaysia 67:363-368. Ministry of Health, Kangar Health Clinic, Jalan Kolam, Kangar, Perlis, Malaysia Allocation of funding within the Ministry of Health of Malaysia […]

Healthcare utilization in patients with Parkinson’s disease: a population-based analysis

Parkinsonism Relat Disord 18:930-935. Movement Disorder Clinic, 200 Woodlawn Street, Winnipeg, MB, Canada PURPOSE: To investigate factors associated with healthcare utilization and prescription drug use […]

Referral of children to specialists in the United States and the United Kingdom

Arch Pediatr Adolesc Med 157:279-285. Department of Health Policy and Management, Health Services Research and Development Center, Bloomberg School of Public Health, Johns Hopkins University, […]

Is quality free? The relationship between cost and quality across 18 provider groups

Am J Manag Care 8:413-422. HealthPartners Research Foundation, Minneapolis, MN, USA OBJECTIVE: To learn whether the healthcare costs for patients of various care delivery systems […]

A patient classification system for our primary care: the Ambulatory Care Groups (ACGs)

Gac Sanit 11:83-94. Published in Spanish. Unitat d’Investigació Centre del Institut Catalá de la Salut, Barcelona, Spain OBJECTIVES: The ambulatory care groups (ACGs) were developed […]

Influence of morbidity, metabolic control, and use of resources in subjects with cardiovascular risk in the primary care setting

Aten Primaria 40:447-454. Published in Spanish. Dirección de Planificación y Desarrollo Organizativo. Badalona Serveis Assistencials S.A. Badalona. Barcelona. España OBJECTIVE: To determine the comorbidity, the […]

Complexity and continuity of treatments among privately insured youth diagnosed with bipolar disorder

Front Psychiatry 1:144. Health Services and Population Research Department, Institute of Psychiatry, King’s College London, London, UK OBJECTIVES: To examine longitudinal patterns of complexity, continuity, […]

Cognitive and behavioral outcomes after early exposure to anesthesia and surgery

Pediatrics 128:e1053-e1061. Erratum in: Pediatrics. 2012 Mar;129(3):595. Department of Anesthesiology, College of Medicine, Mayo Clinic, Rochester, MN, USA BACKGROUND: Annually, millions of children are exposed […]

Use and costs of medical care for children and adolescents with and without attention-deficit/hyperactivity disorder

JAMA 285:60-66. Department of Health Sciences Research, Mayo Clinic, Rochester, MN, USA CONTEXT: A shortage of data exists on medical care use by persons with […]

Use of other opioids during methadone therapy: a population-based study

Addiction 107:776-780. Institute for Clinical Evaluative Sciences, Toronto, ON, Canada AIMS: To determine the extent to which other opioids are prescribed to patients receiving methadone […]

Adaptive capacity of the Adjusted Clinical Groups Case-Mix System to the cost of primary healthcare in Catalonia (Spain): a observational study

BMJ Open 2:2012-000941. Directorate of Planning, Badalona Serveis Assistencials SA, Badalona, Barcelona, Spain OBJECTIVES: To describe the adaptive capacity of the Adjusted Clinical Groups (ACG) […]

Estimating diabetes prevalence in the Military Health System population from 2006 to 2010

Mil Med 178:986-993. Healthcare Informatics Division, United States Air Force Medical Support Agency, San Antonio, TX, USA Evidence-based articles have demonstrated an increase in diabetes […]

Glycemic control associated with secure patient-provider messaging within a shared electronic medical record: a longitudinal analysis

Diabetes Care 36:2726-2733. University of Washington School of Public Health, Seattle, WA, USA; Harvard School of Public Health, Boston, MA, USA; Group Health Research Institute, […]

Direct health-care costs attributed to hip fractures among seniors: a matched cohort study

Osteoporos Int 24:659-669. Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, ON, Canada SUMMARY: Using a matched cohort design, we estimated the mean direct […]

Predictors of dislocation and revision after shoulder stabilization in Ontario, Canada, from 2003 to 2008

Am J Sports Med 41:2034-2040. University of Toronto Orthopaedic Sports Medicine, Women’s College Hospital, Toronto, ON, Canada BACKGROUND: Factors contributing to recurrent dislocation, revision stabilization, […]

Estimating Demand for Care After a Medicaid Expansion: Lessons From Oregon

J Ambul Care Manage. Kaiser Permanente Northwest Center for Health Research, Portland, OR; Oregon Health and Science University, Portland, OR, USA To estimate how the […]

Characteristics of adult primary care patients as predictors of future health services charges

Med Care 39:1170-1181. Department of Community and Family Medicine, Duke University Medical Center, Durham, NC, USA BACKGROUND: Utilization risk assessment is potentially useful for allocation […]

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