Online Program

Teaching Self-efficacy in Managing Disease: A Healthcare Cost Cutting Measure

Tuesday, November 3, 2015

LaTosha Selexman, Harris County Area Agency on Aging, City of Houston Department of Health and Human Services, Houston, TX
Beiyi Cai, MS, Office of Planning, Evaluation and Research for Effectiveness (OPERE), Houston Department of Health and Human Services, Housotn, TX

Patient self-efficacy is the key to prevention and wellness in healthcare reform.  Evidence based practices like Care Transitions Intervention have been instrumental in promoting  self-efficacy of taking care of their health as CMS works to reduce avoidable 30-day hospital readmissions. 


The Care Transitions program identified and enrolled patients who were 60 and older with a primary or secondary diagnosis of CHF and admitted to The Houston Methodist Hospital System from December 1, 2013 – August 30, 2014.  A total of 327 patients were enrolled in the intervention. Thirty day readmission rates were evaluated. To measure patient self-efficacy, the Patient Activation Measure (PAM) was instituted as a means to determine skill-level and confidence in managing personal health.


The Care Transitions Program established a baseline readmission rate of 14.48% which is lower than the CMS national average of 23% established in 2012.  The program, under the guidance of the Houston Methodist Hospital System leadership, created health education tools specifically geared toward HF patients.  In addition, self-management aides and other identified resources were developed and provided to clients as support post-discharge.  The PAM scores were significantly improved for patient according to T-test run by SAS software version 9.3  (p=.015). 


The intervention from the Care Transitions Program may contribute to reducing readmission rates and indicate positive change in patient self-care.  The intervention can be replicated with additional outcome measures such as pneumonia and acute myocardial infarction to reduce hospital readmissions. 

Learning Areas:

Administer health education strategies, interventions and programs
Chronic disease management and prevention
Planning of health education strategies, interventions, and programs

Learning Objectives:
Explain the Care Transitions Intervention and project outcomes Describe health education tools, self-management aides and other identified resources to support patient outcomes Describe patient outcomes related to health self-efficacy score as reported on the Patient Activation Measure (PAM)

Keyword(s): Aging, Self-Efficacy

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I have been the co-principal on federally funded opportunities focusing on providing community-based aging initiatives. My background and experience in providing supportive services to older adults with chronic illnesses has been instrumental in guiding the development of my knowledge in the areas of promoting wellness, providing chronic disease education and promoting empowerment through self-management aides that might assist an older adult to age in place with improved health outcomes successfully.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.

Back to: 4001.0: Chronic Illness Roundtable