Study: Shared Decision Making May Increase Hospital Costs, LOS
May 28—Patient preference for participating in medical decision making may be associated with increased resource utilization and slightly longer length of stay (LOS), according to a study published in JAMA Internal Medicine.
Among the patients who were studied, those who preferred to work with their caregivers to reach decisions spent about 5 percent more time in the hospital and incurred about 6 percent higher costs ($865 more, on average). The study is the first hospital-based one to examine how patients’ desire to participate in medical decisions affects their use of healthcare resources, according to a release about the study.
As part of the study, patients who were admitted to the University of Chicago Medical Center general internal medicine service between July 1, 2003, and August 31, 2011, were surveyed regarding the degree to which they preferred to be involved in medical decision making. Then, hospitalization data were reviewed for the nearly 70 percent of patients who completed the survey (21,754 patients total).
Although 96.3 percent of patients who responded to the survey expressed a desire to receive information about their illnesses and treatment options, 71.1 percent of patients responding to the survey preferred to leave medical decision making to their physicians. Preference to participate in decision making increased with educational level and with private health insurance.
Proponents argue that the shared decision making approach promotes physician-patient communication, enhances patient satisfaction, improves health outcomes, and even may lower cost. However, of the approximately 35 million hospitalizations each year in the United States, if 30 percent of those patients chose to share decision making rather than delegate that role to their physicians, it could mean $8.7 billion of additional costs per year, according to the study.
Publication Date: Tuesday, May 28, 2013