Jessica Greene, Ph.D., and Judith H. Hibbard, Dr.P.H.
J. Greene and J. H. Hibbard, "Why Does Patient Activation Matter? An Examination of the Relationships Between Patient Activation and Health-Related Outcomes," Journal of General Internal Medicine, published online Nov. 30, 2011.
A growing number of quality improvement initiatives in the health care sector seek to encourage patients to play more active roles in managing their care. Recent studies have found that more "activated" patients will have better outcomes, but the evidence is often derived from small sample sizes or from patients' self-reports. This Commonwealth Fund–supported study sought to investigate the extent to which patient activation, as assessed by the Patient Activation Measure (PAM), is related to health and utilization outcomes among a large group of insured patients.
The study compared the PAM scores for 25,047 adult patients with 13 outcomes in four areas: prevention, unhealthy behaviors, clinical indicators, and costly utilization. For 12 of the 13 outcome measures, greater activation was related to better outcomes. For example, for every 10 additional points on the activation measure, patients' probability of having an emergency department visit, being obese, or smoking was 1 percentage point lower. By the same token, 10 additional points on the PAM meant that patients' likelihood of having had a breast cancer screen or having clinical indicators in the normal range—such as for hemoglobin, cholesterol, or triglycerides—was 1 percentage point higher.
The authors conclude that patient activation is strongly related to a broad range of health outcomes and recommend further research to determine how patients can become engaged in their own care. "As health systems and providers seek to survive and thrive in the new payment environment, it will be important to identify effective ways to support patients so that they may be more effective partners in the care process," they conclude.