When Patient Activation Levels Change, Health Outcomes And Costs Change, Too

TLDR

Patient engagement is a major focus of health reform, yet evidence linking increased engagement to better outcomes or lower costs remains limited. The study examined whether a single assessment of patient activation predicts health outcomes and costs over time and whether changes in activation correspond to expected changes in outcomes and costs. Using data from adult primary care patients in a large health system where the Patient Activation Measure is routinely administered, the authors assessed associations between activation levels and outcomes. Higher activation in 2010 was associated with improved clinical indicators, healthier behaviors, increased preventive screening, and lower costs two years later, and changes in activation correlated with improvements in over half of the outcomes and costs, indicating that enhancing activation may support health reform goals and merit further causal investigation.

Abstract

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.