Clinical decision-making: Patients' preferences and experiences

Area of Science:

• Health Services Research
• Patient-Centered Care
• Health Equity

Background:

• Patient preferences for clinical decision-making styles vary.
• Understanding congruence between preferred and experienced styles is crucial for patient satisfaction.
• Socio-economic factors and perceived quality of care may influence this congruence.

Purpose of the Study:

• To assess the alignment between patients' desired and actual clinical decision-making styles.
• To investigate the association of this congruence with socio-economic status.
• To examine the relationship between congruence and perceived quality of regular doctor's care.

Main Methods:

• Cross-sectional survey of the American public.
• Computer-assisted telephone interviewing (CATI) employed for data collection.
• Analysis of 3,209 completed interviews.

Main Results:

• 62% of patients preferred shared decision-making, 28% preferred consumerism, and 9% preferred paternalism.
• 70% of patients experienced their preferred decision-making style.
• Experiencing preferred style was linked to higher income (OR 1.59) and high perceived doctor care quality (OR 2.39).

Conclusions:

• Socio-economic status and high ratings of regular doctor care are independently associated with patients experiencing their preferred decision-making style.
• Continuity of care and strong doctor-patient relationships may enhance health equity by aligning experiences with preferences.