title: Patient activation and disparate health care outcomes in a racially diverse sample of chronically ill older adults.
abstract: The Patient Activation Measure (PAM) assesses people's ability to self-manage their health. Variations in PAM score have been linked with health behaviors, outcomes, and potential disparities. This study assessed the relative impacts of activation, socio-demographic and clinical factors on health care outcomes in a racially diverse sample of chronically ill, elderly homecare patients. Using survey and administrative data from 249 predominantly non-White patients, logistic regression was conducted to examine the effects of activation level and patient characteristics on the likelihood of subsequent hospitalization and emergency department (ED) use. Activation was not a significant predictor of hospitalization or ED use in adjusted models. Non-Whites were more likely than Whites to have a hospitalization or ED visit. Obesity was a strong predictor of both outcomes. Further research should examine potential sources of disadvantage among chronically ill homecare patients to design effective interventions to reduce health disparities in this population.
authors.affiliation: Center for Home Care Policy and Research, Visiting Nurse Service of New York, 5 Penn Plaza, 12th Floor, New York, NY 10001, USA. miriam.ryvicker@vnsny.org
authors.forename: Miriam
authors.initials: M
authors.lastname: Ryvicker
authors.forename: Timothy R
authors.initials: TR
authors.lastname: Peng
authors.forename: Penny Hollander
authors.initials: PH
authors.lastname: Feldman
mesh_terms: D000368:Aged; D002908:Chronic Disease / Q000628:therapy*; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data; D005260:Female; D054625:Healthcare Disparities / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D009519:New York City; D010359:Patient Readmission / Q000706:statistics & numerical data; D044469:Racial Groups / Q000706:statistics & numerical data*; D012648:Self Care / Q000706:statistics & numerical data*; D016896:Treatment Outcome; D014505:Urban Population / Q000706:statistics & numerical data