Patients With Lower Activation Associated With Higher Costs; Delivery Systems Should Know Their Patients' 'Scores'
Patients With Lower Activation Associated With Higher Costs; Delivery Systems Should Know Their Patients' 'Scores'
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DOI：
10.1377/hlthaff.2012.1064
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发表时间：
2013-02-01
期刊：
影响因子：
9.7
通讯作者：
Overton, Valerie
中科院分区：
文献类型：
--
作者：
Hibbard, Judith H.;Greene, Jessica;Overton, Valerie
患者激活这个术语描述了使患者能够积极参与医疗保健的技能和信心。医疗保健服务系统正在将患者激活作为帮助他们及其患者改善结果并影响成本的另一种工具。在本文中，我们研究了患者激活水平与计费护理费用之间的关系。在对明尼苏达州大型医疗保健服务系统 Fairview Health Services 的 33,163 名患者进行分析后，我们发现，与激活水平最高的患者相比，激活水平最低的患者预测的基准年平均成本高出 8%，明年上半年高出 21%，两者均存在显着差异。更重要的是，即使在调整专门用于预测未来成本的常用“风险评分”之后，患者的激活也是成本的重要预测因素。随着医疗保健服务系统逐渐对特定患者群体的成本和结果承担更大的责任，了解患者管理其健康的能力和意愿将成为医疗保健提供者改善结果和降低成本的能力不可或缺的相关信息。
Patient activation is a term that describes the skills and confidence that equip patients to become actively engaged in their health care. Health care delivery systems are turning to patient activation as yet another tool to help them and their patients improve outcomes and influence costs. In this article we examine the relationship between patient activation levels and billed care costs. In an analysis of 33,163 patients of Fairview Health Services, a large health care delivery system in Minnesota, we found that patients with the lowest activation levels had predicted average costs that were 8 percent higher in the base year and 21 percent higher in the first half of the next year than the costs of patients with the highest activation levels, both significant differences. What's more, patient activation was a significant predictor of cost even after adjustment for a commonly used "risk score" specifically designed to predict future costs. As health care delivery systems move toward assuming greater accountability for costs and outcomes for defined patient populations, knowing patients' ability and willingness to manage their health will be a relevant piece of information integral to health care providers' ability to improve outcomes and lower costs.