Patient preference for participating in shared decision making regarding care may increase length of hospital stays and costs of care, according to research published online in JAMA Internal Medicine.
Hyo Jung Tak, Ph.D., of the University of Chicago, and colleagues administered a survey to all patients admitted to the general internal medicine service of the University of Chicago Medical Center from July 2003 through August 2011. Questionnaires were completed by 21,754 patients (69.6 response rate).
The researchers found mean values of 5.34 days for hospital length of stay and $14,576 for cost per stay. Almost all patients (96.3 percent) agreed that they wanted information about their conditions and treatment options. About 71 percent of patients somewhat or definitely agreed with a preference to leave decisions about their medical care to the physician. Preference to share in decision making was more common in those with higher educational level and private insurance coverage. Compared with patients who strongly agreed, patients who somewhat or definitely disagreed with delegating medical decision making to the physician had a 0.26-day longer length of hospital stay and $865 more in total costs per stay.
“Patient preference to participate in decision making concerning their care may be associated with increased resource utilization among hospitalized patients,” the authors write. “Variation in patient preference to participate in medical decision making and its effects on costs and outcomes in the presence of varying physician incentives deserve further examination.”