Department of Planning, Public Policy & Management, 1209 University of Oregon, Eugene, OR 97405, USA.
J Gen Intern Med. 2012 May;27(5):520-6. doi: 10.1007/s11606-011-1931-2.
There is a growing awareness that patients should be more active and effective managers of their health and health care. Recent studies have found patient activation--or having the knowledge, skills, and confidence to manage one's health, to be related to health-related outcomes. These studies have often relied on self-reported outcomes and often have used small samples.
To examine the degree to which patient activation is related to a broad range of patient health and utilization outcomes in a large, insured population.
Cross-sectional study of patients at Fairview Health Services in Minnesota. Data on patient activation and patient outcomes were derived from the electronic health record, abstracted in December 2010.
A total of 25,047 adult patients were included in the analysis. They all had a primary care visit in the prior six months and completed the patient activation measure as part of an office visit.
The key independent measure was the Patient Activation Measure. We examined 13 patient outcomes across four areas: prevention, unhealthy behaviors, clinical indicators, and costly utilization.
In multivariate models, patient activation was related to 12 of 13 patient outcomes in the expected direction. For every additional 10 points in patient activation, the predicted probability of having an ED visit, being obese, or smoking was one percentage point lower. The likelihood of having a breast cancer screen or clinical indicators in the normal range (A1c, HDL, and triglycerides) was one percentage point higher.
This cross sectional study finds that patient activation is strongly related to a broad range of health-related outcomes, which suggests improving activation has great potential. Future work should examine the effectiveness of interventions to support patient activation.
越来越多的人认识到，患者应该更加积极主动地管理自己的健康和医疗保健。最近的研究发现，患者激活——即拥有管理自己健康的知识、技能和信心——与健康相关的结果有关。这些研究往往依赖于自我报告的结果，并且经常使用小样本。
在一个大型参保人群中，考察患者激活与广泛的患者健康和利用结果之间的关系程度。
明尼苏达州费尔维尤健康服务的横断面研究。患者激活和患者结果的数据来自电子健康记录，于 2010 年 12 月提取。
共有 25047 名成年患者纳入分析。他们都在过去六个月内进行了一次初级保健就诊，并在就诊时完成了患者激活测量。
主要的独立测量指标是患者激活测量。我们考察了四个领域的 13 项患者结果：预防、不良行为、临床指标和高成本利用。
在多变量模型中，患者激活与 13 项患者结果中的 12 项呈预期方向相关。患者激活每增加 10 分，急诊就诊、肥胖或吸烟的预测概率就会降低一个百分点。进行乳腺癌筛查或临床指标（A1c、HDL 和甘油三酯）处于正常范围的可能性就会增加一个百分点。
这项横断面研究发现，患者激活与广泛的健康相关结果密切相关，这表明改善激活具有很大的潜力。未来的工作应该检验支持患者激活的干预措施的有效性。
