Patient participation in decision making may raise cost of care, study shows

BMJ 2013; 346 doi: (Published 04 June 2013) Cite this as: BMJ 2013;346:f3597
  1. Michael McCarthy
  1. 1Seattle

Increasing the participation of patients in healthcare decision making may prolong the length of stays in hospital and increase the cost of care, a new US study has found. Extrapolating the study’s results to the national scale, the researchers concluded that patient participation could cost an extra $8.7bn (£5.7bn; €6.7bn) a year.

Three other studies published online at the same time by the journal JAMA Internal Medicine showed that, though some patients wanted a bigger role in their treatment decisions, doctors often failed to explain the pros and cons of interventions or to be candid with patients about prognoses.

The first study, that showing the increased cost of decision sharing, gathered data from 21 754 patients admitted to the University of Chicago Medical Center. It found that 71% of patients said that they preferred to leave medical decisions to their physicians.1 Patients with higher educational levels and who had private insurance were more likely to say that they would like to take part in decision making. But after controlling for such factors as age, race or ethnicity, self reported health assessment, comorbidities, and admission diagnoses, the researchers found that patients keen on being involved in healthcare decision making had longer stays in hospital and higher hospital treatment costs.

Compared with the 8181 (38%) patients who had a strong desire to leave decision making in the hands of their doctors, the 6287 (29%) patients who …

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