Why Does Patient Activation Matter? An Examination of the Relationships Between Patient Activation and Health-Related Outcomes
Why Does Patient Activation Matter? An Examination of the Relationships Between Patient Activation and Health-Related Outcomes
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DOI：
10.1007/s11606-011-1931-2
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发表时间：
2012-05-01
影响因子：
5.7
通讯作者：
Hibbard, Judith H.
中科院分区：
文献类型：
--
作者：
Greene, Jessica;Hibbard, Judith H.
人们越来越意识到，患者应该成为更积极、更有效的健康和医疗保健管理者。最近的研究发现，患者的活跃--或者说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。这些研究通常依赖于自我报告的结果，并且通常使用小样本。在大量有保险的人群中，检查患者激活与广泛的患者健康和利用结果的关系的程度。明尼苏达州美景医疗服务公司患者的横断面研究。关于患者活动和患者预后的数据来自2010年12月提取的电子健康记录。总共有25047名成年患者被纳入分析。他们都在前六个月进行了初级保健访问，并作为办公室访问的一部分完成了患者激活措施。关键的独立衡量标准是患者激活措施。我们从预防、不健康行为、临床指标和昂贵的使用四个方面检查了13名患者的结果。在多变量模型中，患者的激活与13名患者中的12名在预期方向上的结果相关。患者活跃度每增加10个百分点，预测的急诊室就诊、肥胖或吸烟的概率就会降低一个百分点。乳腺癌筛查或临床指标(A1c、高密度脂蛋白和甘油三酯)在正常范围内的可能性高一个百分点。这项横断面研究发现，患者的激活与一系列与健康相关的结果密切相关，这表明改善激活具有巨大的潜力。未来的工作应该检查支持患者激活的干预措施的有效性。
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.