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Enhanced support for shared decision making reduced costs of care for patients with preference-sensitive conditions

Health Affairs, 2013-02, Vol.32 (2), p.285-293 [Peer Reviewed Journal]

Copyright The People to People Health Foundation, Inc., Project HOPE Feb 2013 ;ISSN: 0278-2715 ;EISSN: 1544-5208 ;EISSN: 2694-233X ;DOI: 10.1377/hlthaff.2011.0941 ;PMID: 23381521

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Title:
Enhanced support for shared decision making reduced costs of care for patients with preference-sensitive conditions
Author: Veroff, David ; Marr, Amy ; Wennberg, David E
Subjects: Back pain ; Cost control ; Cost Control - methods ; Cost Control - organization & administration ; Cost reduction ; Decision Making ; Delivery of Health Care - economics ; Delivery of Health Care - methods ; Female ; Health Care Costs ; Health care expenditures ; Health care policy ; Health insurance ; Humans ; Male ; Medical treatment ; Medicare ; Middle Aged ; Patient Participation - economics ; Patient Participation - methods ; Patient Preference - economics ; Patients ; Physicians ; Pilot projects ; Population ; Preferences ; Quality improvement ; Quality of care ; Quality of Health Care - economics ; Quality of Health Care - organization & administration ; Review boards ; Studies ; Support groups ; Surgery
Is Part Of: Health Affairs, 2013-02, Vol.32 (2), p.285-293
Description: Shared decision making is an approach to care that seeks to fully inform patients about the risks and benefits of available treatments and engage them as participants in decisions about the treatments. Although recent federal and state policies pursue the expanded use of shared decision making as a way to improve care quality and patient experience, payers and providers want evidence that this emerging model of care is cost-effective. We examined data obtained from a year-long randomized investigation. The study compared the effects on patients of receiving a usual level of support in making a medical treatment decision with the effects of receiving enhanced support, which included more contact with trained health coaches through telephone, mail, e-mail, and the Internet. We found that patients who received enhanced support had 5.3 percent lower overall medical costs than patients who received the usual level of support. The enhanced-support group had 12.5 percent fewer hospital admissions than the usual-support group, and 9.9 percent fewer preference-sensitive surgeries, including 20.9 percent fewer preference-sensitive heart surgeries. These findings indicate that support for shared decision making can generate savings. They also suggest that a "remote" model of support-combining telephonic coaching with decision aids, for example-may constitute a relatively low-cost and effective intervention that could reach broader populations without the need for the direct involvement of regular medical care team members.
Publisher: United States: The People to People Health Foundation, Inc., Project HOPE
Language: English
Identifier: ISSN: 0278-2715
EISSN: 1544-5208
EISSN: 2694-233X
DOI: 10.1377/hlthaff.2011.0941
PMID: 23381521
Source: AUTh Library subscriptions: ProQuest Central
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Enhanced support for shared decision making reduced costs of care for patients with preference-sensitive conditions

Copyright The People to People Health Foundation, Inc., Project HOPE Feb 2013 ;ISSN: 0278-2715 ;EISSN: 1544-5208 ;EISSN: 2694-233X ;DOI: 10.1377/hlthaff.2011.0941 ;PMID: 23381521

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