Patient activation and disparate health care outcomes in a racially diverse sample of chronically ill older adults

J Health Care Poor Underserved. 2012 Nov;23(4):1577-89. doi: 10.1353/hpu.2012.0157.

Abstract

The Patient Activation Measure (PAM) assesses people's ability to self-manage their health. Variations in PAM score have been linked with health behaviors, outcomes, and potential disparities. This study assessed the relative impacts of activation, socio-demographic and clinical factors on health care outcomes in a racially diverse sample of chronically ill, elderly homecare patients. Using survey and administrative data from 249 predominantly non-White patients, logistic regression was conducted to examine the effects of activation level and patient characteristics on the likelihood of subsequent hospitalization and emergency department (ED) use. Activation was not a significant predictor of hospitalization or ED use in adjusted models. Non-Whites were more likely than Whites to have a hospitalization or ED visit. Obesity was a strong predictor of both outcomes. Further research should examine potential sources of disadvantage among chronically ill homecare patients to design effective interventions to reduce health disparities in this population.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Chronic Disease / therapy*
  • Emergency Service, Hospital / statistics & numerical data
  • Female
  • Healthcare Disparities / statistics & numerical data
  • Humans
  • Male
  • New York City
  • Patient Readmission / statistics & numerical data
  • Racial Groups / statistics & numerical data*
  • Self Care / statistics & numerical data*
  • Treatment Outcome
  • Urban Population / statistics & numerical data