Theory and practice of decision making in coronary care in general practice

Decisions about coronary care made by 39 randomly selected general practitioners in New Zealand over one year were investigated. Demographic variables and variables relating to the patient's condition, history, and social circumstances were assessed for 113 patients, and practitioners' belief about the relevance of each variable to the decision was elicited. A comparison was made between the objective criteria found to be related to the decision, the criteria believed by the practitioners to be relevant to the decision, and a theoretical model of what should govern the decision to admit. The theoretical model was found to be built into the beliefs of the practitioners, but the objective model was far simpler. Further research is needed to determine whether the use of the more complex, theoretical models will confer any benefit, in terms of patient wellbeing, over the pragmatic model in use at present.