Publicatie datum

Less activated patients have higher health care costs: a comparative study in a Dutch sample of diabetes patients.

Hendriks, M., Plass, A.M.C., Rademakers, J. Less activated patients have higher health care costs: a comparative study in a Dutch sample of diabetes patients. European Journal of Public Health: 2013, 23(Suppl. 1), p. 80. Abstract. 6th European Public Health Conference: Health in Europe: are we there yet? Learning from the past, building the future. 13-16 November 2013, Brussel.
Lees online
Background: Patients and especially the chronically ill are expected to play an active role in their health care management. They are to be involved, well-informed and to be able to adjust their behavior to maintain a good health. Different levels of patient activation have been associated with distinct self-care and other health-related behaviors. The assumption is that lower patient activation is also related to health care use, leading to higher health care costs. Methods: Diabetes patients of a Dutch health insurer filled out the Patient Activation Measure (PAM) 13-Dutch. The PAM was filled out by 693 diabetes patients in 2011 and by 2,998 diabetes patients in 2012. Information on health care use and costs were extracted from the claims data of the health insurer for the years 2009, 2010 and 2011. Using ANOVA analyses, we examined the differences in healthcare use and costs between four levels of patient activation. Results: Less activated patients had higher healthcare costs for general practice care, allied health care, hospital care, mental care, pharmaceutical care, assistive devices and reimbursements towards the primary healthcare package (P’s < 0.01). Especially patients scoring in the lowest activation level (level 1) had higher costs. Looking at all the reimbursements towards the primary healthcare package, for instance, patients scoring in level 1 claimed on average 6,100 Euro year versus 4,255–4,886 Euro per year for the other three groups. Costs for assistive devices specific for diabetes did not differ between the four levels of patient activation (P = 0.212). Similar results were found for health care use. Conclusions: Differences in health care use and costs can be explained by differences in patient activation. The next step will be to establish whether the PAM can be used in clinical practice to identify patients most in need for help with managing their healthcare and to monitor the effectiveness of interventions in increasing patient activation.