Patient Information and Surgery Decisions: A Discrete Choice Experiment

Area of Science:

• Health Economics
• Medical Decision Making
• Surgical Outcomes Research

Background:

• Surgical procedures are increasingly common, even for elderly and high-risk individuals.
• Patient understanding of surgical risks and non-surgical alternatives is often incomplete.
• This knowledge gap is particularly concerning for high-risk patients where non-surgical options may be more relevant.

Purpose of the Study:

• To investigate the impact of information provision and non-surgical treatment availability on high-risk patients considering hip replacement.
• To model incorrect beliefs about post-surgery outcomes and limited non-surgical options.
• To quantify welfare loss associated with these factors in the UK context.

Main Methods:

• Development of a discrete choice model.
• Estimation using an online choice experiment with participants acting as hypothetical high-risk patients.
• Randomized provision of information on post-surgery outcomes and physiotherapy availability.

Main Results:

• Participant beliefs about post-surgery outcomes systematically differed from predicted outcomes.
• Information provision had varied effects on the accuracy of these beliefs.
• Excluding physiotherapy as a treatment option contributed to four-fifths of the total welfare loss.
• Incorrect beliefs about post-surgery outcomes accounted for the remaining welfare loss.
• Educational attainment was a significant predictor of welfare loss due to inaccurate beliefs.

Conclusions:

• Information deficits and limited non-surgical options significantly impact high-risk patients' decision-making and welfare.
• Physiotherapy's exclusion from treatment options represents a substantial source of welfare loss.
• Targeted educational interventions can mitigate welfare loss stemming from inaccurate patient beliefs regarding surgical risks.