Health care costs more for least ‘activated’

U. OREGON (US) — Patients with the motivation, knowledge, skills, and confidence to manage their own health have better health outcomes and incur fewer health care costs.

The new study shows that patients with the lowest level of “activation”—that is, those most lacking in the skills and confidence to be actively engaged in their health care—had average costs that were from 8 percent to 21 percent higher compared to patients with the highest level of activation.

“The study highlights the important role that patients play in determining outcomes,” Judith Hibbard, professor emerita in the department of planning, public policy, and management at the University of Oregon.


“We found that patients who were more knowledgeable, skilled, and confident about managing their day-to-day health and health care—also called patient activation—had health care costs that were substantially lower than patients who lacked this type of confidence and skill.”

Using a Patient Activation Measure that assesses beliefs, knowledge, and confidence in managing health-related tasks, the researchers found that patient scores on a questionnaire that ranks patient activation showed that patients’ responses in effect predicted their overall care costs—even when adjusted by the severity of patients’ health conditions, age, sex, and income.

Hibbard’s two papers, appearing in the February edition of Health Affairs, are co-authored by Professor Jessica Greene, director of research at the George Washington University School of Nursing and former associate professor at the University of Oregon.

In one paper, they examine the relationship between patient activation levels and billed care costs by analyzing 33,163 patients of Fairview Health Services, a large health care delivery system in Minnesota.

The other paper looks at a broad array of research on patient activation. Hibbard and Greene examined the larger body of research in order to draw conclusions and point out areas in need of further study.

They call for a systematic approach in encouraging patients to play a more active role in their health care and determine that policies and interventions aimed at strengthening patients’ roles in managing their health care can contribute to improved outcomes.

Source: University of Oregon