When patient activation levels change, health outcomes and costs change, too.
Patient engagement has become a major focus of health reform. However, there is limited evidence showing that increases in patient engagement are associated with improved health outcomes or lower costs. We examined the extent to which a single assessment of engagement, the Patient Activation Measure, was associated with health outcomes and costs over time, and whether changes in assessed activation were related to expected changes in outcomes and costs. We used data on adult primary care patients from a single large health care system where the Patient Activation Measure is routinely used. We found that results indicating higher activation in 2010 were associated with nine out of thirteen better health outcomes-including better clinical indicators, more healthy behaviors, and greater use of women's preventive screening tests-as well as with lower costs two years later. Changes in activation level were associated with changes in over half of the health outcomes examined, as well as costs, in the expected directions. These findings suggest that efforts to increase patient activation may help achieve key goals of health reform and that further research is warranted to examine whether the observed associations are causal.
Jessica Greene (jessgreene@gwu.edu) is a professor in the School of Nursing, the George Washington University, in Washington, D.C.
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Judith H. Hibbard is a professor emerita and senior researcher in the Health Policy Research Group ISE, University of Oregon, in Eugene.
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Rebecca Sacks is a research assistant in the School of Nursing, the George Washington University.
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Valerie Overton is vice president for quality and innovation at the Fairview Medical Group, in Minneapolis, Minnesota.
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Carmen D. Parrotta is a performance improvement consultant at the Fairview Medical Group.
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D000328:Adult; D000367:Age Factors; D003362:Cost-Benefit Analysis; D005260:Female; D017048:Health Care Costs; D018166:Health Care Reform / Q000458:organization & administration; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D010358:Patient Participation / Q000191:economics / Q000706:statistics & numerical data*; D011320:Primary Health Care / Q000191:economics* / Q000458:organization & administration; D011787:Quality of Health Care / Q000191:economics*; D018570:Risk Assessment; D012737:Sex Factors; D014481:United States
Consumer Issues; Health Spending; Quality Of Care