Are Patients Really Getting What They Want? The Routine Implementation of Decision Aids for Patients with Hip or Knee Osteoarthritis in the High Value Healthcare Collaborative and Alignment between Patient Treatment Choice and Receipt
| Autor: | Vanessa B. Hurley |
|---|---|
| Rok vydání: | 2020 |
| Předmět: |
medicine.medical_specialty
Osteoarthritis Medicare Logistic regression Osteoarthritis Hip Decision Support Techniques Odds 03 medical and health sciences Health care Decision aids Humans Medicine Aged Retrospective Studies Receipt Treatment choices business.industry 030503 health policy & services Health Policy Public Health Environmental and Occupational Health Retrospective cohort study Osteoarthritis Knee medicine.disease United States Orthopedic surgery Physical therapy Patient Participation 0305 other medical science business Delivery of Health Care |
| DOI: | 10.22541/au.160630029.91213521/v1 |
| Popis: | Rationale, Aims and Objectives: Alignment between patients’ treatment choices and treatments received is acknowledged as an important outcome of shared decision-making (SDM), yet recent research suggests that patients’ choices do not always align with their actual treatment trajectories. This paper explores the alignment of patient-expressed treatment choices (for surgery or medical management) after exposure to decision aids and treatments received among patients with hip or knee osteoarthritis within High Value Healthcare Collaborative (HVHC) systems as the collaborative integrating decision aids intended to support SDM into routine clinical practice. Method: This retrospective cohort study examines data from adult (>18 years) patients with hip or knee osteoarthritis who received decision aids as part of orthopedic consultations within HVHC systems between 2012-2015. Multivariate logistic regression explored the association between patient-level characteristics with the odds of treatment choice-receipt alignment. Results: The majority of patients with knee osteoarthritis (68.3%) and hip osteoarthritis (71.9%) received treatments aligned with their choices following exposure to decision aids, but analyses reveal important differences in the odds of such alignment across patient characteristics. In adjusted models, African American patients with knee osteoarthritis had 50% lower odds of receiving treatment aligned with their choices compared with white patients (OR = 0.52, p |
| Databáze: | OpenAIRE |
| Externí odkaz: |
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