Abstract
To ascertain changes in shared decision making (SDM), we analyzed data from the nationally representative Medical Expenditure Panel Survey. We aggregated responses to questions into a 7-point SDM composite score. Between 2002 and 2014, the mean SDM composite score increased from 4.4 to 5.0 (P <.01), indicating greater patient-perceived SDM. In multivariate modeling, SDM scores were higher for black vs white patients (+0.33 points) and those with a same-race/ethnicity usual source of care (+0.24 points; both P <.05). Scores were lower for patients with poor-perceived health (−0.41 points), Asian vs white race/ethnicity (−0.28 points), and no insurance (−0.17 points; all P <.05). Improvement efforts should target Americans without a same-race/ethnicity usual source of care and with poor-perceived health.
- shared decision making
- patient-centered care
- clinical decision-making
- decision support techniques
- primary care
Footnotes
↵* Dr Landon and Dr Linder contributed equally to this manuscript
Conflicts of interest: authors report none.
Funding support: Dr Levine received funding support from an Institutional National Research Service Award (T32HP10251), the Ryoichi Sasakawa Fellowship Fund, and the Brigham and Women’s Hospital Division of General Internal Medicine and Primary Care.
Disclaimer: All funding sources had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; and decision to submit the manuscript for publication.
Previous presentation: Presented at the Society of General Internal Medicine – New England Regional Meeting; March 9, 2017; Boston, Massachusetts.
Author contributions: D.M.L. had full access to all of the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis; Study concept and design: D.M.L.; Acquisition, analysis, or interpretation of data: all authors; Drafting of the manuscript: D.M.L.; Critical revision of the manuscript for important intellectual content: all authors; Statistical analysis: D.M.L.; Administrative, technical, or material support: D.M.L.; Study supervision: B.E.L. and J.A.L.
Supplementary materials: Available at http://www.AnnFamMed.org/content/15/6/552/suppl/DC1/.
- Received for publication January 27, 2017.
- Revision received June 14, 2017.
- Accepted for publication July 7, 2017.
- © 2017 Annals of Family Medicine, Inc.