RESUMEN

ObjectivePatient engagement, as measured by the Patient Activation Measure (PAM®), has been used to assess patients' ability to manage their own care. This study aimed to determine whether the PAM® could predict healthcare use in older adults aged >70years, living independently in the community with mild frailty, within 30days after emergency department (ED) discharge.MethodsA prospective single-centre observational cohort study was completed including older adults who presented to an ED. The 13-item PAM® and selected International Consortium for Health Outcomes Measures were completed prior to ED discharge.ResultsTwo hundred patients were recruited with a mean age of 84.8years (s.d. 6.9). The mean PAM® score was 58.6 (s.d. 13.3), with 12.5% at Level 1 (n=25), 40% at Level 2 (n=80), 34.5% at Level 3 (n=69) and 13.0% at Level 4 (n=26). The PAM® level was significantly associated with ED presentations in the past 6months (P=0.030). The PAM® level did not predict healthcare use within 30days of discharge consisting of time until ED representation (P=0.557), number of ED representations (P=0.560), number of hospital admissions (P=0.499), length of stay in hospital (P=0.254) and number of post-discharge contacts (P=0.667).ConclusionsOverall, the PAM® did not predict prospective short-term healthcare use. However, the PAM® was significantly associated with 6-month previous ED use. With more than 50% of patients at Level 1 or 2, indicating lower capacity for self-management, tailored interventions are required to assist mildly frail patients to manage discharge care plans and engage in preventative strategies.