Does patient activation predict the course of type 2 diabetes? A longitudinal study.

Objective: To examine whether patient activation is predictive of the course of diabetes over a three year period among patients with and without diabetes.

Methods: Longitudinal analyses utilized electronic health record data from 2011 to 2014. We examined how the patient activation measure (PAM) was predictive of 2014 diabetes-related outcomes among patients with diabetes (n=10,071); pre-diabetes (n=1804); and neither diabetes nor pre-diabetes (n=46,402).

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.

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.

Adding A Measure Of Patient Self-Management Capability To Risk Assessment Can Improve Prediction Of High Costs.

We explored whether supplementing a clinical risk score with a behavioral measure could improve targeting of the patients most in need of supports that reduce their risk of costly service utilization. Using data from a large health system that determines patient self-management capability using the Patient Activation Measure, we examined utilization of hospital and emergency department care by the 15 percent of patients with the highest clinical risk scores. After controlling for risk scores and placing patients within segments based on their level of activation in 2011, we found that the lower the activation level, the higher the utilization and cost of hospital services in each of the following three years.

When patient activation levels change, health outcomes and costs change, too.

Patient engagement has become a major focus of health reform. However, there is limited evidence showing that increases in patient engagement are associated with improved health outcomes or lower costs. We examined the extent to which a single assessment of engagement, the Patient Activation Measure, was associated with health outcomes and costs over time, and whether changes in assessed activation were related to expected changes in outcomes and costs.

Tax levy financing for local public health: fiscal allocation, effort, and capacity.

Background: Local health departments (LHDs) rely on a wide variety of funding sources, and the level of financing is associated with both LHD performance in essential public health services and population health outcomes. Although it has been shown that funding sources vary across LHDs, there is no evidence regarding the relationship between fiscal allocation (local tax levy); fiscal effort (tax capacity); and fiscal capacity (community wealth).

Purpose: The purpose of this study is to analyze local tax levy support for LHD funding.

Developing a taxonomy for the science of improvement in public health.

Context: Quality improvement (QI) methods have been used for almost a decade in public health departments to increase effectiveness and efficiency. Although results are rapidly accumulating, the evidence for the science of improvement is shallow and limited. To advance the use and effectiveness of QI in public health, it is important to develop a science of improvement using practice-based research to build an evidence base for QI projects.

Development of a magnetic particle immunoassay for polybrominated diphenyl ethers and application to environmental and food matrices.

A sensitive magnetic particle enzyme-linked immunoassay (ELISA) was developed to analyze polybrominated diphenyl ethers (PBDEs) in water, milk, fish, and soil samples. The assay was rapid and can be used to analyze fifty samples in about 1h after sample cleanup. The assay has a limit of detection (LOD) below 0.