In a study report hitting the digital wires on Health Affairs at 4pm Eastern time today (March 2, 2015), a group of researchers are reporting the results of a longitudinal study of Patient Activation Measure (PAM) impact on cost and outcome metrics from a large study cohort. The results show that activated, engaged patients have better outcomes, at lower costs, than do their less-activated peers. For expert/savvy patients and other policy wonks, this might seem a little like a “dispatch from the desk of Captain Obvious,” but the more research-study bricks built into the wall of what ePatient Dave calls “people who are informed better, perform better,” … well, this is a wheelbarrow full of bricks.
From Stacey Bailey, communications leader at the Gordon and Betty Moore Foundation, which funded the study:
In the largest, longitudinal investigation to date (conducted over two years), researchers from George Washington University, University of Oregon and Fairview Medical Group assessed the relationship between changes in a person’s activation level and changes in health outcomes and cost and found they were associated. They examined activation levels of more than 32,000 adult patients at Fairview Health Services (a large non-profit health care system in Minnesota) using the Patient Activation Measure. The measure, as you likely know, has four levels of activation with one being the lowest and four being the highest. Over a two-year time period some findings include:
People with higher activation levels show nine of 13 better health outcomes, including health indicators associated with HDLs and triglycerides, preventative screenings and avoiding hospitalization.
People who were at the lowest levels had significantly lower odds of having positive outcomes for seven of 13 health indicators compared to those who remained at level four in both time periods.
Similar patterns appeared when examining the activation levels and billed costs. When people stayed at the highest level of activation over the study period their projected costs were 31 percent lower than for people who stayed at the lowest levels.
Costs for people moving up or down levels, also moved in the same direction as their activation level changes. People who moved down from activation level four to three over one year were 14 percent higher than those who stayed in level four. Those moving from three or four down to levels one or two had projected costs that were 27 percent higher than those who were in level four both years (lowest average per capita cost $6,411).
Spread the word – participatory medicine makes a difference. Keep adding bricks to that wall.