Parkinson MD, Hammonds T, Keyser DJ, Wheeler JR, Peele PB. Impact of Physician Referral to Health Coaching on Patient Engagement and Health Risks: An Observational Study of UPMC's Prescription for Wellness.
Am J Health Promot 2020;
34:366-375. [PMID:
32048859 DOI:
10.1177/0890117119900588]
[Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
PURPOSE
Evaluate impact of physician referral to health coaching on patient engagement and health risk reduction.
DESIGN
Four-year retrospective, observational cohort study with propensity-matched pair comparisons.
SETTING
Integrated delivery and finance system in Pittsburgh, Pennsylvania.
SAMPLE
10 457 adult insured members referred to health coaching by their physician; 37 864 other members identified for health coaching through insurer-initiated outreach.
INTERVENTION
Practice-based, technology-supported workflow and process for physician prescribing of health coaching during regular office visit, with follow-up on patient's progress and implementation supports.
MEASURES
Patient engagement based on completion of pre-enrollment assessment, formal enrollment in health coaching, completion of required sessions, health risk levels, and number of health risks pre- and post-health coaching referral.
ANALYSIS
Difference-in-difference analysis to assess change in health risk levels and number of health risks pre- and post-health coaching and probability weighting to control for potential confounding between groups.
RESULTS
Members referred by a physician were significantly more likely to enroll in a health coaching program (21.0% vs 6.0%, P < .001) and complete the program requirements (8.5% vs 2.7%, P < .001) than when referred by insurer-initiated outreach; significant within group improvement in health risk levels from baseline (P < .001) was observed for both the groups.
CONCLUSIONS
Patients are significantly more likely to engage in health coaching when a referral is made by a physician; engagement in health coaching significantly improves health risk levels.
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