Confident, involved patients get better care, lower costs

The more active the role patients take in their health care, the more likely they are to receive high-quality care at a lower cost.

Patients who were more knowledgeable, skilled and confident about managing their day-to-day health and health care sometimes had substantially lower medical costs than those who lacked this skill or confidence, according to research by Judith Hibbard, professor emeritus with the Health Research Group at the University of Oregon.

Hibbard led a 2013 study that analyzed electronic medical records data from 33,163 adults who were part of a large health care delivery system in Minnesota. Researchers measured the patients on a 0 to 100 scale based on their agreement with statements such as: “I know how to prevent problems with my health.” Or, “I am confident that I can tell a doctor my concerns, even when he or she does not ask.”

Researchers focused specifically on conditions that required patients to take an active management role, such as: asthma, diabetes, hypertension and high cholesterol.

The results showed that average health care costs were 8 percent to 21 percent higher for patients who  were not as engaged in their care (those who scored 25 or under).

“We know that people who score higher have better health behaviors, more screening, engage more in positive behaviors, more likely to ask questions. And more likely to adhere to medications that are prescribed to them,” Hibbard said.

How does a patient become more active in their care? Hibbard and a colleague found support groups,  coaching, and education in self-care led to healthier behaviors and fewer hospitalizations.

The takeaway message for health care policy makers, providers and consumers who want high-quality, affordable care: “Patients are part of the solution.”