Impact of medical care coordination intervention on patient activation

To evaluate the impact of an adult medical care coordination (AMCC) intervention on patient activation.

This observational evaluation compared AMCC with usual care (UC). Eligible patients were adults discharged home who had 2 or more chronic conditions and a high risk of readmission. AMCC involved registered nurse care coordinators providing self-management support to patients via 1 home visit and regular phone calls. The outcome was the 10-item Patient Activation Measure (PAM), a validated patient-reported outcome tool with 4 levels ranging from 1 (lower activation) to 4 (higher activation). Measurement occurred at baseline and 30, 90, and 180 days.

We evaluated patient activation as an ordinal outcome using an ordered logistic regression model, a dichotomous outcome using a linear probability model, and a continuous outcome using ordinary least squares.

We identified 915 (432 AMCC, 483 UC) patients who completed both the baseline and at least 1 follow-up PAM. For the ordinal analysis, AMCC was associated with a significant increase in the percentage with a PAM of level 3 at 30, 90, and 180 days and a decrease in the percentage with a PAM of level 1 or 2 at 180 days. For the dichotomous analysis, AMCC was associated with a significant increase in the percentage of patients with a PAM of level 3 or 4 at 180 days (15.2 percentage points; 95% CI, 5.6-24.7).

AMCC significantly increased patient activation, particularly at the final measurement. These findings highlight the potential value of AMCC as a self-management intervention, enhancing patients' confidence to manage their health.