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Using Shared Decision-Making Tools and Patient-Clinician Conversations About Costs
Nataly R Espinoza Suarez1,2, Christina M LaVecchia1,3, Oscar J Ponce1
1Knowledge and Evaluation Research (KER) Unit, Mayo Clinic, Rochester, MN.
Mayo Clinic Proceedings. Innovations, Quality & Outcomes
|August 15, 2020
Summary
Shared decision-making (SDM) tools increase patient-clinician cost conversations. However, these tools alone are insufficient for addressing patient cost concerns or offering solutions.
Area of Science:
- Health Services Research
- Patient-Centered Care
- Clinical Communication
Background:
- Cost is a significant factor in healthcare decisions.
- Shared decision-making (SDM) aims to involve patients in their care.
- The impact of SDM tools on cost discussions is not fully understood.
Purpose of the Study:
- To evaluate the effect of SDM tools on cost conversations between patients and clinicians.
- To determine if SDM tools influence the incidence and nature of cost discussions during clinical encounters.
Main Methods:
- Analysis of 220 video-recorded clinical encounters from randomized trials.
- Comparison of encounters with and without SDM tools designed to address cost.
- Secondary analysis conducted in 2018 on trials from 2007-2015.
Main Results:
- SDM tools increased general (62% vs 36%) and medication-specific (89% vs 51%) cost conversations.
- Clinicians were less likely to address cost issues when using SDM tools (37% vs 51%).
- Patients with lower educational attainment had more cost conversations.
Conclusions:
- SDM tools can initiate cost conversations but do not adequately support them.
- The current SDM tools are insufficient for comprehensively addressing patients' cost concerns.
- Further research is needed to develop SDM tools that effectively support cost discussions.
Keywords:
SDM, shared decision-makingMore Related Videos
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