Professor Judith H. Hibbard, Professor of Health Policy, University of Oregon talks about increasing patient activation to improve outcomes and reduce costs at The King's Fund Annual Conference.

1. Increasing patient activation to improve outcomes and reduce costs Judith H. Hibbard Institute for Policy and Research Innovation University of Oregon

3. The focus on patient-centered care

4. Patients are an important resource in health care

6. target the types of support and information patients and consumers need

8. key insights

9. implications

12. Interval Level

13. Guttman-Like ScaleUnidimensional Interval Level Guttman-like

14. Activation is developmental Source: J.Hibbard, University of Oregon

15. Activation level is predictive of behaviours Research consistently finds that those who are more activated are: engaged in more preventive behaviours engaged in more healthy behaviours engaged in more disease specific self-management behaviours engaged in more health information-seeking behaviours.

16. Level of activation is linked with behaviours Source: US National sample 2004

17. Behaviours in medical encounter by activation level

19. Many of the behaviours we are asking of people are only done by those in highest level of activation

20. When we focus on the more complex and difficult behaviours – we discourage the least activated

22. Activation can predict utilisationand health outcomes two years into the future for diabetics Carol Remmers. The Relationship Between the Patient Activation Measure, Future Health Outcomes, and Health Care Utilization Among Patients with Diabetes. Kaiser Care Management Institute, PhD Dissertation. Multivariate analysis which controlled for age group, gender, race, comorbidities and number of diabetes-related prescriptions.

23. Low activation signals problems (and opportunities) 14

24. What specific interventions have been shown to increase activation? Stanford CDSMP (peer support and problem-solving) Worksite programmes – environmental Tailored coaching Clinician support

26. Improve efficiencies

27. Improve efficacy

28. Population-based approaches

31. Examined changes in claims data, clinical indicators, and activation levels

34. Testing interventions that increase activation in the clinical setting

35. Care transitions and reducing hospital re-admissions