Patient Activation Changes as a Potential Signal for Changes in Health Care Costs: Cohort Study of US High-Cost Patients
| Autor: | Alan Glaseroff, Steven M. Asch, Judith H. Hibbard, Derek B. Boothroyd, Ann Lindsay |
|---|---|
| Rok vydání: | 2018 |
| Předmět: |
Male
medicine.medical_specialty Psychological intervention Medicare Cohort Studies 03 medical and health sciences 0302 clinical medicine Cost Savings Health care Internal Medicine Medicine Humans 030212 general & internal medicine Prospective Studies Prospective cohort study health care economics and organizations Aged Original Research Aged 80 and over Health economics business.industry Medicaid 030503 health policy & services Health Care Costs Middle Aged Confidence interval United States Cohort Emergency medicine Female Patient Participation 0305 other medical science business Cohort study Follow-Up Studies |
| Zdroj: | Journal of general internal medicine. 33(12) |
| ISSN: | 1525-1497 |
| Popis: | BACKGROUND: Programs to improve quality of care and lower costs for the highest utilizers of health services are proliferating, yet such programs have difficulty demonstrating cost savings. OBJECTIVE: In this study, we explore the degree to which changes in Patient Activation Measure (PAM) levels predict health care costs among high-risk patients. PARTICIPANTS: De-identified claims, demographic data, and serial PAM scores were analyzed on 2155 patients from multiple medical groups engaged in an existing Center for Medicare and Medicaid Innovation-funded intervention over 3 years designed to activate and improve care coordination for high-risk patients. DESIGN: In this prospective cohort study, four levels of PAM (from low to high) were used as the main predictor variable. We fit mixed linear models for log(10) of allowed charges in follow-up periods in relation to change in PAM, controlling for baseline PAM, baseline costs, age, sex, income, and baseline risk score. MAIN MEASURES: Total allowed charges were derived from claims data for the cohort. PAM scores were from a separate database managed by the local practices. KEY RESULTS: A single PAM level increase was associated with 8.3% lower follow-up costs (95% confidence interval 2.5–13.2%). CONCLUSIONS: These findings contribute to a growing evidence base that the change in PAM score could serve as an early signal indicating the impact of interventions designed for high-cost, high-needs patients. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (10.1007/s11606-018-4657-6) contains supplementary material, which is available to authorized users. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|
Full text from SpringerLink