A new study involving more than 22,000 patients at the University of Chicago Medical Center and which has been published in the online edition of JAMA Internal Medicine reveals that patients who opted to participate in the decision making process regarding their care had longer length of stay and higher hospitalization costs compared to others.
Hyo Jung Tak, Ph.D., and colleagues examined the relationship between patient preferences for participation in medical decision making and health care utilization among patients hospitalized between July 1, 2003 and August 31, 2011 by asking patients to complete a survey. The survey data were then linked with administrative data, including length of stay and total hospitalization costs. Nearly all of the patients indicated they wanted information about their illnesses and treatment options, but just over 70 percent preferred to leave the medical decisions to their physician. "Preference to participate in medical decision making increased with educational level and with private health insurance," the authors note. "Patients who preferred to participate in decision making concerning their care had a 0.26-day longer length of stay and $865 higher total hospitalization costs."
In conclusion the authors write: "That patient preference for participation is associated with increased resource use contrasts with some perspectives on shared decision making that emphasize reductions of inappropriate use. However, in the presence of physician incentives to decrease use, such as exist for hospitalized patients and are likely to increase under health reform, increased resource use may occur. Future studies related to patient participation in decision making should examine effects on both outcomes and costs."
(JAMA Intern Med. Published online May 27, 2013. doi: 10.1001/jamainternmed.2013.6048.