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

background

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. 

methods

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.

results

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). 

conclusion

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.