Could shared decision making affect staying in hospital? A cross-sectional pilot study

Abstract

BackgroundShared Decision Making (SDM) is an approach where clinicians and patients share the best available evidence to make decision and where patients opinions are considered. This approach provides benefits for patients, clinicians and health care system. The aim of the present study is to investigate the patients’ perception of their participation in treatment choices and to identify the possible influences of variables in decision aids and therapeutic choices. Furthermore the present study evaluates the impact of SDM on the length of hospital stay and the health expenditure in Piemonte, an Italian region.MethodsA cross-sectional study was performed in 2016. The patients were selected after hospitalization to clinical and surgical units at the Rivoli and Susa Hospital. Data were collected through the questionnaire and the Hospital Discharge Registers. STROBE guidelines for observational studies were used. A descriptive analysis was conducted. Frequencies and percentages of the categorical variables were reported. Statistical analyses were performed using t-test, chi-square test and Mann-Whitney test.ResultsThe final sample was made of 174 subjects. More than half of the sample reported a SDM approach. Female gender (p = 0.027) and lower age (p = 0.047) are associated with an increased possibility to report SDM. Receiving “good” or “excellent” information, having their own request fulfilled and their opinions took into account by healthcare professionals, were all found to be predictors for an approach recognized as SDM (p ≤ 0.05). The perception that healthcare professionals spent a proper amount of time with the patients and used an understendable language are factors increase the chance of a “shared” decision process (p ≤ 0.05). The patients trust in the information given by the healthcare professional is not affecting their perception about the decision making process (P = 0.195). No significant difference where recorded in length of stay and hospital expenditure.ConclusionsThe data show the role played by different dimension of the patients-clinician relationship and that the strongest determinant of a perceived shared decision making approach are healthcare professional-depending.

Association of Delivery Outcomes With the Number of Childbirth Education Sessions

“…42,44 Shared decision-making has limited effect when it begins during a hospitalization, and the time constraints of the labor and delivery experience are a barrier to pregnant people examining options and values as they might for other healthcare services. 45 One factor that increases the use of shared decision-making is patient education. 46 Childbirth education conducted over 3 or more sessions provides pregnant people with the time needed to review what they have learned and may function similarly to enhanced decision support from a trained health coach.…”

What role do patients prefer in medical decision-making?: a population-based nationwide cross-sectional study

“…The effect of this consultation model in Length of Stay and Costs Among Hospitalized Patients is still a controversial issue. Some studies suggest that it does not affect, 7 or may even increase, 8 length of hospital stay and health costs. However, it is important to note that even if there is an increase in associated costs, if these are reflected in better patient satisfaction and an improvement in health outcomes, they can be seen as a benefit.…”

Information about different treatment options and shared decision making in dialysis care - a retrospective survey among hemodialysis patients

“…Shared decision making (SDM) aims to ensure patients are informed about their medical conditions, treatment options and resulting benefits and harms, so that they can participate in their medical decision making [ 1 ]. A shared decision requires both parties to be informed about the possible aspects relevant for the treatment decision [ 2 ]. This also includes information about all treatment alternatives.…”