Suzanne Mitchell|Paula Gardiner|Ekaterina Sadikova|Jessica Martin|Brian Jack|Judith H. Hibbard|Michael K. Paasche?Orlow
Patient Activation and 30-Day Post-Discharge Hospital Utilization
Boston University|Boston University|Boston University|Boston University|Boston University|University of Oregon|Boston University
patient activation linked better health outcomes lower rates health service utilization role patient activation rate hospital readmission within 30 days hospital discharge examined secondary analysis using data project redlit randomized controlled trial conducted urban safety net hospital data 695 englishspeaking general medical inpatient subjects analyzed used adapted eightitem version validated patient activation measure pam total scores categorized according standardized methods one four pam levels activation level 1 lowest activation level 4 highest activation primary outcome measure total 30day postdischarge hospital utilization defined total emergency department ed visits plus hospital readmissions including observation stays poisson regression used control confounding 695 subjects 67 96 pam level 1 123 177 level 2 193 278 level 3 312 449 level 4 compared highly activated patients pam level 4 higher rate 30day postdischarge hospital utilization observed patients lower levels activation pam level 1 incident rate ratio irr 175 95 ci118 260 pam level 2 irr 150 95 ci 106 213 rate returning hospital among patients pam level 3 statistically different patients pam level 4 irr 130 95 ci 094 180 rate ratio pam level 1 also higher compared level 4 ed use alone 168107 263 hospital readmissions alone 193 122 306 hospitalized adult medical patients urban academic safety net hospital lower levels patient activation higher rate postdischarge 30day hospital utilization