In the last decades, the increased epidemiology of chronic conditions, due to the aging of the population and to the diffusion of environmental stressors, has implied an enhanced organizational and economic effort of the healthcare system. In this scenario, healthcare experts, managers, and policy makers are recognizing the importance of a paradigm shift in the planning and delivery of healthcare in the favor of promoting a more active role of patients in the management of their healthcare.

Beyond the rhetorical call for increasing patient’s engagement, policy makers recognize the urgency to have an evidence-based measure of patient’s engagement and capture its effect when planning and implementing initiatives aimed at sustaining the engagement of consumers in their health. The scale was developed based on conceptualization of patient engagement. Having a valid and reliable measure to assess patient engagement is the first step in understanding patient engagement and its role in health care quality, outcomes, and cost containment.

To engage patients in healthcare is considered across the world as a key strategy to improve patients’ adherence, clinical outcomes, and satisfactions toward the received care. Furthermore, the achievement of a concrete engagement of patients in their healthcare management has also been envisaged as an effective strategy to reduce healthcare costs.


Patient Activation Measure


Patient Activation Measure (PAM) is an interval-level, unidimensional Guttman-like measure that contains items measuring self-assessed knowledge about chronic conditions, beliefs about illness and medical care, and self-efficacy for self-care. The PAM focused on physical conditions, and it was designed to measure activation as a broad construct.


Demographic and Clinical Variables


A set of ad hoc items were included in the questionnaire in order to describe socio-demographic and clinical characteristics of the patients. Those also served as screening variables in order to select panel respondents. These items were related particularly to the following patients’ characteristics: age; gender; education; marital status; type of diagnosis; year from the first diagnosis.


Health Economics and an Aging Population


Health care expenditures for persons in their last year of life presently account for over 25% of Medicare spending. By 2050, the population aged 80 and older is projected at 30.9 million, a 300% increase from the 11.3 million in 2010. This population is expected to be both more ethnically diverse and have more chronic conditions than previous generations. With the rapid increase in the aging population, a core focus in Telehealth and population health planning is placed on engaging the population in conversations surrounding their values and beliefs. The capacity for providers to provide personalized medicine to patients, now and in the future, is reliant on stable avenues of communication between the patient and care provider paired with technological capabilities robust enough to access, document, exchange, share, and store vital data retrieved as information.

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