Research Activities, March 2014
Patient activation level affects likelihood of 30-day rehospitalization
Patient Safety and Quality of Care
Research suggests that a successful post-hospital care transition depends on the patient's ability to manage their discharge care plan upon returning home. The knowledge, skills, confidence, and inclination to assume responsibility for managing one's health and health care needs is often referred to as "patient activation." A new study found that patients with high activation levels had reduced likelihood of being rehospitalized within 30 days of hospital discharge.
The researchers used an eight-item version of the Patient Activation Measure (PAM) to categorize 695 general medical inpatients into four levels, based on their degree of patient activation. Compared with the most highly activated patients (PAM level 4), a higher rate of 30-day post-discharge hospitalization was observed for patients with lower activation levels (levels 1 and 2). Patients at level 3 were not statistically different from those at level 4. Level 1 patients also had higher ED use alone and hospital use alone compared with level 4 patients.
Hospital readmissions and emergency department visits in the 30 days after hospital discharge are common and costly. Other key risk factors for early unplanned hospital reuse include depression, low health literacy, male gender, advanced age, complex medication regimens, and taking certain high-risk medications. The researchers concluded that patients with a low level of activation are at risk for early unplanned hospital use. They suggest that hospitals can use the measurement of patient activation as a predictor of hospital reutilization in order to effectively target their efforts in preventing readmission. The study was supported in part by AHRQ (HS19771).
See "Patient activation and 30-day post-discharge hospital utilization," by Suzanne E. Mitchell, M.D., Paul M. Gardner, M.D., Ekaterina Sadikova, M.P.H., and others in the Journal of General Internal Medicine published online October 4, 2013.