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Impact of rheumatoid arthritis on receiving a diagnosis of hypertension among patients with regular primary care

Arthritis Care Res Department of Medicine, Rheumatology Division, University of Wisconsin, Madison, WI, USA OBJECTIVE: Despite numerous studies reporting increased cardiovascular disease (CVD) in patients […]

Comorbidity of dementia: a cross-sectional study of primary care older patients

BMC Psychiatry 14:84. EpiChron Research Group on Chronic Diseases, Aragón Health Sciences Institute (IACS), University Hospital, Zaragoza, Spain BACKGROUND: The epidemiologic study of comorbidities of […]

The impact of morbidity trajectories on identifying high-cost cases: using Taiwan’s National Health Insurance as an example

J Public Health 36:300-307. Department of Health Policy & Management, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA. BACKGROUND: Incorporating longitudinal information […]

Exploring the Johns Hopkins Aggregated Diagnosis Groups in administrative data as a measure of child health

This study explored the utility of the Johns Hopkins Aggregated Diagnostic Groups (ADGs) as a noncategorical measure of child health in administrative health data. Canadian […]

The hassle of wellness: do peers and health status matter?

In: Population Association of America, eds. 2014 Annual Meeting, Population Association of America. Princeton, NJ, USA: Population Association of America. Cornell University, Ithaca, NY, USA […]

A data-driven approach towards patient identification for telehealth programs

2015 IEEE International Conference on Big Data :2551-2559. Robert Bosch (US), Palo Alto, CA, USA Telehealth provides an opportunity to reduce healthcare costs through remote […]

An actuarial perspective on healthcare expenditure in the last year of life

Washington, DC: International Congress of Actuaries. University of Cape Town, South Africa The aim of this paper is to highlight the key methodological considerations in […]

A hierarchical multivariate two-part model for profiling providers’ effects on health care changes

J Am Statistical Assoc 101:911-923. Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA Procedures for analyzing and comparing health care providers’ effects on […]

Risk adjustment in state Medicaid programs

Health Watch :14-17, 32-34. Denver, Colorado, office of Wakely Consulting Group This article discusses some of the most important considerations in implementing risk adjustment within […]

Health-based risk adjustment: application to premium development and profiling

In: Wrightson CW, eds. Financial strategy for managed care organizations: rate setting, risk adjustment, and competitive advantage. Ann Arbor, MI, USA: Health Administration Press:165-225. Health […]

Evaluation of casemix adjustment methods for the Massachusetts Division of Medical Assistance

Massachusetts Rate Setting Commission. Final report and recommendation. Boston, MA, USA: Massachusetts Rate Setting Commission. Massachusetts Rate Setting Commission, Boston, MA, USA We investigated methods […]

How well do models work? Predicting health care costs

In: American Statistical Association, eds. Proceedings of the Section on Statistics in Epidemiology. Alexandria, VA, USA: American Statistical Association:42-49. Department of General Internal Medicine, Boston […]

A risk stratification model for adult patients with obstructive sleep apnea: development and evaluation

Toronto, ON, Canada: Institute for Clinical Evaluative Sciences. Institute for Clinical Evaluative Sciences, Toronto, ON, Canada STUDY HYPOTHESES: We hypothesize that the apnea-hypopneas index (AHI), […]

Studying effects of primary care physicians and patients on the trade-off between charges for primary care and specialty care using a hierarchical multivariate two-part model

Department of Biostatistics Working Paper 51. Baltimore, MD, USA: Johns Hopkins University. Johns Hopkins University, Baltimore, MD, USA OBJECTIVE. To examine effects of primary care […]

An incentive mechanism for using risk adjuster to reimburse health care provider

York, UK: University of York. University of York, York, UK Health care providers are almost always universally reimbursed by third party purchasers. As a result, […]

Prompt reduction in use of medications for comorbid conditions after bariatric surgery

Rockville, MD, USA: Agency for Healthcare Research and Quality. Johns Hopkins University, Baltimore, MD, USA BACKGROUND. Bariatric surgery leads to weight loss, but it is […]

The dynamic effects of medical risk costs: evidence from quantile regression

Journal of Statistics and Management Systems 14:843-868. This paper adopted the quantile regression (QR) estimator to assess the effects of the medical utilization factors (changes […]

An economic analysis of secure messaging between patients and providers

Seattle, WA, USA: University of Washington (doctoral dissertation). University of Washington, Seattle, WA, USA This dissertation presents an economic analysis of patient-provider communication through secure […]

Comorbilidad y discapacidad en pacientes con insuficiencia cardiaca

Madrid, Spain: Universidad Autonoma de Madrid (doctoral dissertation). Published in Spanish. Universidad Autonoma de Madrid, Madrid, Spain INTRODUCCIÓN: La insuficiencia cardiaca (IC) es un problema […]

Thiazolidinedione use and risk of hospitalization for pneumonia in type 2 diabetes:  population based matched case-control study

F1000Research 2:145. Department of Medicine, Johns Hopkins University Schools of Medicine and Public Health, Baltimore, MD, USA OBJECTIVE: Previous randomized clinical trials and their meta-analyses […]

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.

Facilitating Equity and Efficiency in Primary Health Care

Johns Hopkins University Facilitating Equity & Efficiency in Primary Health Care, Malaysia using the ACG Case Mix System Dr Karen Kinder Executive Director

Tuesday-Re-thinking ACG fundamentals-Kitching and Heim

HealthPartners Risk Adjustment in Total Cost of Care & Resource Use: Re-Thinking Risk Adjustment Chad Heim Gary Kitching

Monday-US Health Reform-Ewald

Minnesota Department of Human Services The MN Health Care Home Initiative and ACG Dean Ewald

Monday-Care Coordination II-Haas

Mayo Clinic Assessment of Risk Stratification Methods Identifying Patients for Care Coordination within a Medical Home Lindsey R. Haas, MPH

Pilot study using Risk Stratification in Thames

Richmond Clinical Commissioning Group Using ACG to Support Delivery of Integrated Care Anna Raleigh, Consultant in Public Health Dr Caoimhe O Sullivan, Public Health Principal […]

Health Insurance Marketplace

DST Health Solutions Health Insurance Marketplace Amy Salls

Monday(C4)-Identifying Near Term Heath Cost Risk in the Absence of Claims Data—Bernard Khomenko

Identifying Near Term Heath Cost Risk  in the Absence of Claims Data   —Bernard Khomenko, CEBS Vice President of Client Solutions, Data Smart Solutions 

Tuesday(C8)-Using the ACG Software for a Full Picture of Population Risk Under the Accountable Care Act (ACA)-Salls and Bodycombe

Using the ACG Software for a Full Picture of Population Risk Under the Accountable Care Act (ACA) —Amy Salls, DST Health Solutions  David Bodycombe, Johns […]

The Future of the ACG System

Hadi Kharrazi, MD, PhD, Assistant Professor Health Policy and Management, Johns Hopkins Bloomberg School of Public Health talks about EMRs, other future data sources and […]

Predictors of hospital stay and home care services use: A population-based, retrospective cohort study in stage IV gastric cancer

Background: Home care services use has been proposed as a means of reducing costs in palliative care by decreasing hospital stay without impacting quality of […]

Albuminuria, Reduced Kidney Function, and the Risk of ST‐ and non–ST‐segment–elevation myocardial infarction

Abstract Background Chronic kidney disease is a recognized independent risk factor for cardiovascular disease, but whether the risks of ST‐segment–elevation myocardial infarction (STEMI) and non–ST‐segment–elevation […]

Correlation between Potentially Inappropriate Medication and Alzheimer’s Disease among the Elderly

Abstract   Purpose This study is conducted to explore the association between potentially inappropriate medication (PIM) and Alzheimer’s disease (AD) among the elderly. Methods We […]

Variation in the health outcomes associated with frailty among home care clients: relevance of caregiver distress and client sex

Abstract Background The identification of contextual factors that modify associations between client frailty and their health and service use outcomes is essential for informed home […]

The Incremental Health Care Costs of Frailty Among Home Care Recipients With and Without Dementia in Ontario, Canada: A Cohort Study

Abstract Objective In this study, we investigated the incremental 1-year direct costs of health care associated with frailty among home care recipients in Ontario with and without […]

Do Incentive Payments Reward The Wrong Providers? A Study Of Primary Care Reform In Ontario, Canada

ABSTRACT Primary care payment reform in the US and elsewhere usually involves capitation, often combined with bonuses and incentives. In capitation systems, providing care within […]

Economic Analysis of Adjuvant Chemoradiotherapy Compared with Chemotherapy in Resected Pancreas Cancer

Abstract Background Population-based survival and costs of pancreas adenocarcinoma patients receiving adjuvant chemoradiation and chemotherapy following pancreaticoduodenectomy are poorly understood. Methods This retrospective cohort study used […]

Incremental healthcare utilisation and costs among new senior high-cost users in Ontario, Canada: a retrospective matched cohort study

Abstract Objectives To describe healthcare use and spending before and on becoming a new (incident) senior high-cost user (HCU) compared with senior non-HCUs; to estimate […]

Diagnostic accuracy of administrative codes for autosomal dominant polycystic kidney disease in clinic patients with cystic kidney disease

Abstract Background The ability to identify patients with autosomal dominant polycystic kidney disease (ADPKD) and distinguish them from patients with similar conditions in healthcare administrative […]

Correlates of non-adherence to breast, cervical, and colorectal cancer screening among screen-eligible women: a population-based cohort study in Ontario, Canada

Abstract Purpose Breast, cervical, and colorectal cancers are cancers that can be detected early through screening. Despite organized cancer screening programs in Ontario, Canada participation […]

Comparing the Predictive Effects of Patient Medication Adherence Indices in Electronic Health Record and Claims-Based Risk Stratification Models

Abstract Multiple indices are available to measure medication adherence behaviors. Medication adherence measures, however, have rarely been extracted from electronic health records (EHRs) for population-level […]

In-Person and Telehealth Ambulatory Contacts and Costs in a Large US Insured Cohort Before and During the COVID-19 Pandemic

Abstract Importance This study assesses the role of telehealth in the delivery of care at the start of the COVID-19 pandemic. Objectives To document patterns […]

Class III Obesity and Other Factors Associated with Longer Wait Times for Endometrial Cancer Surgery: A Population-Based Study

Abstract Objective To evaluate the impact of class III obesity (body mass index >40 kg/m2) on wait times for endometrial cancer surgery in Ontario, as […]

Evaluating the performance of a predictive modeling approach to identifying members at high-risk of hospitalization

Abstract Aims To evaluate the risk-of-hospitalization (ROH) models developed at Blue Cross Blue Shield of Louisiana (BCBSLA) and compare this approach to the DxCG risk-score […]

Impact of Area Deprivation Index on the Performance of Claims-Based Risk-Adjustment Models in Predicting Health Care Costs and Utilization

Abstract Objective Traditionally, risk-adjustment models do not address the characteristics of minority populations, such as race or socioeconomic status. This study aimed to evaluate the […]

Long-term risk of subsequent major osteoporotic fracture and hip fracture in men and women: a population-based observational study with a 25-year follow-up

Abstract Summary The risk of subsequent major osteoporotic and hip fracture following an initial fracture was increased in both sexes over 25 years, with modest […]

Association of Surgical Experience With Risk of Complication in Total Hip Arthroplasty Among Patients With Severe Obesity

Abstract Importance Severe obesity is a risk factor for major early complications after total hip arthroplasty (THA). Objective To determine the association between surgeon experience […]

Outpatient Physical Therapy Use Following Tibial Fractures: A Retrospective Commercial Claims Analysis

Abstract Objective The purpose of this study was to characterize outpatient physical therapy (OPT) use following tibial fractures and examine the variability of OPT attendance, […]

Time since prior fracture affects mortality at the time of clinical assessment: a registry‑based cohort study

Abstract Summary Fractures are associated with increased long-term mortality in patients surviving to undergo baseline DXA. Notably, excess mortality risk does not decline with increasing […]

Impact of Frailty on Hospital Outcomes Among Patients with Lymphoid Malignancies Receiving Autologous Hematopoietic Stem Cell Transplantation in the United States

Abstract Background Frailty could affect outcomes of autologous hematopoietic stem cell transplantation (aHSCT). This study sought to examine the effects of frailty on hospital outcomes […]

Relationship of frailty with excess mortality during the COVID-19 pandemic: a population-level study in Ontario, Canada

Abstract Background There is a paucity of the literature on the relationship between frailty and excess mortality due to the COVID-19 pandemic. Methods The entire […]

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 […]

Identifying High-Risk Medicare Advantage Enrollees

Early identification of high-risk members provides the opportunity to manage the complex needs of this population. After one month in the plan, more than 50% […]

Case Mix Adjustment in Practice

In this webinar, builds upon the introduction to the concept of case mix in the previous webinar and will share how case mix adjustment can […]

Improving the quality of outpatient care for older patients with diabetes: lessons from a comparison of rural and urban communities

J Fam Pract 50:676-680. University of Washington, Department of Family Medicine, Seattle, WA, USA OBJECTIVE: Our goal was to compare the quality of diabetic care […]

Why do physicians vary so widely in their referral rates?

J Gen Intern Med 15:163-168. Department of Family Medicine, University of Rochester, Rochester, NY, USA OBJECTIVE: To determine which physician practice and psychological factors contribute […]

Assessing population health care need using a claims-based ACG morbidity measure: a validation analysis in the province of Manitoba

Health Serv Res 37:1345-1364. Centre for Health Services and Policy Research, University of British Columbia, Vancouver, BC, Canada OBJECTIVES: To assess the ability of an […]

Health care costs, utilization and patterns of care following Lyme disease

PLoS One 10:e0116767. Johns Hopkins Bloomberg University, Baltimore, MD, USA BACKGROUND: Lyme disease is the most frequently reported vector borne infection in the United States. […]

Palliative care and the aggressiveness of end-of-life care in patients with advanced pancreatic cancer

J Natl Cancer Inst 107:p11: kju424. University Health Network, Toronto, ON, Canada; Institute of Medical Sciences, Toronto, ON, Canada BACKGROUND: We examined the impact of […]

Predicting costs of care using a pharmacy-based measure risk adjustment in a veteran population

Med Care 41:753-760. VA Puget Sound Health Care System, Seattle, WA, USA BACKGROUND: Although most widely used risk adjustment systems use diagnosis data to classify […]

Process of care for Medicaid-enrolled children with asthma: served by community health centers and other providers

Med Care 40:303-314. Institute for Health Care Research and Policy, Georgetown Public Policy Institute, Georgetown University, Washington, DC, USA OBJECTIVE: To compare the process of […]

A population-based study evaluating family physicians’ HIV experience and care of people living with HIV in Ontario

Ann Fam Med 13:436-445. Bruyère Research Institute, Ottawa, ON, Canada; University of Ottawa, Ottawa, ON, Canada; Ottawa Hospital Research Institute, Ottawa, ON, Canada; Institute for […]

Sex disparities in post-acute myocardial infarction pharmacologic treatment initiation and adherence: problem for young women

Circ Cardiovasc Qual Outcomes 8:586-592. University of British Columbia, Vancouver, BC, Canada BACKGROUND: The prevalence of the use of secondary prevention cardiovascular medications is lower […]

Increased surgeon experience with rheumatoid arthritis reduces the risk of complications following total joint arthroplasty

Arthritis Rheumatol 66:488-496. University of Toronto and Women’s College Hospital, Toronto, ON, Canada OBJECTIVE: To determine the relationship between surgeon experience with, and complications following, […]

Prevalence, expenditures, and complications of multiple chronic conditions in the elderly

Arch Intern Med 162:2269-2276. Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA BACKGROUND: The prevalence, health care […]

Ambulatory care groups: a categorization of diagnoses for research and management

Health Serv Res 26:53-74. Department of Health Policy and Management, Johns Hopkins School of Hygiene and Public Health, Baltimore, MD, USA This article describes a […]

Using the Johns Hopkins aggregated diagnosis groups (ADGs) to predict mortality in a general adult population cohort in Ontario, Canada

Med Care 49:932-939. Institute for Clinical Evaluative Sciences, Department of Health Management, Policy and Evaluation, University of Ottawa, Ottawa, ON, Canada BACKGROUND: Administrative healthcare databases […]

Preventable hospitalizations and socioeconomic status.

Health Aff 17:177-189. Wagner Graduate School, New York University, New York, NY, USA. “Preventable” hospitalizations have been proposed as indicators of poor health plan performance. […]

Applying diagnosis and pharmacy-based risk models to predict pharmacy use in Aragon, Spain: the impact of a local calibration

BMC Health Serv Res 10:22. Aragon Health Science Institute, Zaragoza, Spain BACKGROUND: In the financing of a national health system, where pharmaceutical spending is one […]

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) […]

Exploratory analysis of high CT scan utilization in claims data

J Am Coll Radiol 11:51-58. University of Minnesota, Minneapolis, MN. USA; Arizona State University, Tempe, AZ, USA PURPOSE: This study explores characteristics that distinguish higher […]

Increased risk of complications following total joint arthroplasty in patients with rheumatoid arthritis

Arthritis Rheumatol 66:254-263. University of Toronto, Toronto, ON, Canada OBJECTIVE: Most of the evidence regarding complications following total hip arthroplasty (THA) and total knee arthroplasty […]

High-risk case identification for use in comprehensive complex care management

Popul Health Manag. Clalit Research Institute , Chief Physician’s Office, Clalit Health Services, Tel Aviv, Israel . The current study aimed to develop a patient […]

Association of the Hospital Volume of Frail Surgical Patients Cared for with Outcomes after Elective, Major Noncardiac Surgery

Background: Frailty is a risk factor for adverse postoperative outcomes. Hospitals that perform higher volumes of surgery have better outcomes than low-volume providers. We hypothesized […]

A health insurance plan with wellness features

Ithaca, NY, USA: Cornell University (doctoral dissertation). Cornell University, Ithaca, NY, USA Employers are increasingly using wellness programs to improve health and lifestyle of employees. […]

Medi-Cal and managed care: risk, costs, and regional variation

Sacramento, CA, USA: Public Policy Institute of California. Rollins School of Public Health, Emory University, Atlanta, GA; School of Public Health, University of Alabama at […]

Impact of center case volume on cardiotoxicity during adjuvant trastuzumab in breast cancer

2013 American Society of Clinical Oncology Annual Meeting. Abstract 6625. J Clin Oncol 31 (suppl; abstr 6625). University of Toronto, Toronto, ON, Canada; St. Michael’s […]

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