The level of patient activation—a person's ability to manage his or her health and health care—varies considerably in the U.S. population, with less than half of adults (41.4%) at the highest level, according to a national study released today by the Center for Studying Health System Change (HSC).
The Patient Activation Measure (PAM) was designed to assess individuals’ knowledge, skill and confidence in managing their health and consists of a 13-item scale that asks people about their beliefs, knowledge, and confidence for taking an active role in their health and health care. HSC's 2007 Health Tracking Household Survey is the first large nationally representative survey--information on 13,500 adults--to include the PAM to assess the level of activation in the U.S. population. HSC is a nonpartisan health policy research organization funded in part by the Robert Wood Johnson Foundation, which funded the survey and the study.
Activation levels are especially low for people with low incomes, less education, Medicaid enrollees, and people with poor self-reported health. Higher activation levels are associated with much lower levels of unmet need for medical care and greater support from healthcare providers for self-management of chronic conditions, according to the study. "Because activation is changeable, it is a potentially important lever for change in the healthcare system," said Judith Hibbard, Dr. P.H., of the University of Oregon, coauthor of the study with HSC Senior Fellow Peter J. Cunningham, Ph.D.
