A study by physicians at Boston Medical Center (BMC), has found that patients with a high degree of activation (possessing the knowledge, skills, confidence and inclination to assume responsibility for managing one's health and health-care needs) were less likely to be readmitted to the hospital within 30 days of discharge than those with a low level of activation. This study, which appears online in Journal of General Internal Medicine, is the first to evaluate patient activation and its effects on utilization of hospital services after discharge.
Hospital readmissions within 30 days of discharge cost Medicare an estimated $17.4 billion s annually and present a great challenge to reducing health care costs. As reimbursement for hospital readmission declines in the current health-care climate, understanding patient factors leading to readmission is a potential avenue for reducing cost and improving care.
Data from 695 patients were analyzed and categorized into four levels of patient activation, level 1 (lowest activation) vs. level 4 (highest activation). The study concluded that patients with low activation had nearly twice the risk of 30-day post-discharge hospital service utilization compared with patients with higher activation.
According to the researchers identifying patients at risk for unplanned hospitalization following discharge presents an opportunity for intervention. "Our results suggest that access to greater services is not sufficient to avoid readmissions, but that available resources need to be tailored to the patient's individual needs," explained lead author Suzanne Mitchell, MD, MS, lead author of the study and family medicine physician at BMC. "These results reinforce a recent emphasis on targeted patient education during hospitalization," she added.
- Suzanne E. Mitchell, Paula M. Gardiner, Ekaterina Sadikova, Jessica M. Martin, Brian W. Jack, Judith H. Hibbard, Michael K. Paasche-Orlow. Patient Activation and 30-Day Post-Discharge Hospital Utilization. Journal of General Internal Medicine, 2013; DOI: 10.1007/s11606-013-2647-2
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