The Neglected Topic

J. S. Blumenthal-Barby, Emily Robinson, Scott B. Cantor, Aanand D. Naik, Heidi Voelker Russell and Robert J. Volk

Medical Decision Making, 2015, vol. 35, issue 4, 412-418

Abstract: Costs are an important component of patients’ decision making, but a comparatively underemphasized aspect of formal shared decision making. We hypothesized that decision aids also avoid discussion of costs, despite their being tools designed to facilitate shared decision making about patient-centered outcomes. We sought to define the frequency of cost-related information and identify the common modes of presenting cost and cost-related information in the 290 decision aids catalogued in the Ottawa Hospital Research Institute’s Decision Aid Library Inventory (DALI) system. We found that 56% ( n = 161) of the decision aids mentioned cost in some way, but only 13% ( n = 37) gave a specific price or range of prices. We identified 9 different ways in which cost was mentioned. The most common approach was as a “pro†of one of the treatment options (e.g., “you avoid the cost of medication†). Of the 37 decision aids that gave specific prices or ranges of prices for treatment options, only 2 were about surgery decisions despite the fact that surgery decision aids were the most common. Our findings suggest that presentation of cost information in decision aids is highly variable. Evidence-based guidelines should be developed by the International Patient Decision Aid Standards (IPDAS) Collaboration.

Keywords: decision aids; cost; decision making; consumer issues; health economics; ethical issues (search for similar items in EconPapers)
Date: 2015
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Persistent link: https://EconPapers.repec.org/RePEc:sae:medema:v:35:y:2015:i:4:p:412-418

DOI: 10.1177/0272989X14564433

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