Context-based patient choice management in healthcare

Area of Science:

• Healthcare Management
• Patient Decision-Making
• Health Services Research

Background:

• Limited understanding and experience exist regarding patient choice management in healthcare settings.
• Effective patient choice management requires understanding decision-making processes within specific clinical contexts.

Purpose of the Study:

• To apply and test demand-supply-based operating (DSO) logic within a clinical setting to clarify patient choice contexts.
• To investigate patient choice-making behaviors across different contexts.
• To propose context-based architectural strategies for managing and developing patient choice.

Main Methods:

• Utilized prenatal screening and testing in the Helsinki and Uusimaa Hospital District (HUS) as a case study.
• Contextualized choice points using the DSO framework.
• Conducted semi-structured interviews with women undergoing prenatal screening and testing, followed by thematic analysis of their reflections, behaviors, and experiences.

Main Results:

• Identified four relevant choice contexts within prenatal care: prevention, cure, electives, and continuous care, using DSO logic.
• Observed distinct choice-making patterns among women in prevention and cure contexts, differing in activeness, information needs, social influence, preferences, emotional status, and difficulty.
• Found that default choices were widely accepted in prevention mode, while individual counseling facilitated informed choices in cure mode.

Conclusions:

• The DSO model effectively contextualizes patient choice within a specific care episode, highlighting variations in choice-making across different contexts.
• Context-based choice architectures are proposed to enhance patient choice management and development.
• Tailoring choice management strategies to specific care contexts, such as prevention versus cure, is essential for improving patient engagement and decision quality.