Improving Population Health Management Strategies: Identifying Patients Who Are More Likely to Be Users of Avoidable Costly Care and Those More Likely to Develop a New Chronic Disease.

ABSTRACT:

Objective

To explore using the Patient Activation Measure (PAM) for identifying patients more likely to have ambulatory care-sensitive (ACS) utilization and future increases in chronic disease.

Data sources

Secondary data are extracted from the electronic health record of a large accountable care organization.

Study design

This is a retrospective cohort design. The key predictor variable, PAM score, is measured in 2011, and is used to predict outcomes in 2012-2014. Outcomes include ACS utilization and the likelihood of a new chronic disease.

Data

Our sample of 98,142 adult patients was drawn from primary care clinic users. To be included, patients had to have a PAM score in 2011 and at least one clinic visit in each of the three subsequent years.

Principal f

SUBMITTER: Hibbard JH 

PROVIDER: S-EPMC5517668 | biostudies-literature | 2017 Aug

REPOSITORIES: biostudies-literature