The Effect of Total Cost Information on Consumer Treatment Decisions: An Experimental Survey

Regina Kwon, Larry A. Allen, Laura D. Scherer, Jocelyn S. Thompson, Madiha F. Abdel-Maksoud, Colleen K. McIlvennan and Daniel D. Matlock
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Regina Kwon: Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
Larry A. Allen: Division of Cardiology, Department of Medicine, University of Colorado School of Medicine, Aurora, CO, USA
Laura D. Scherer: Department of Psychological Sciences, University of Missouri, Columbia, MO, USA
Jocelyn S. Thompson: Adult and Child Consortium for Health Outcomes Research and Delivery Science, University of Colorado School of Medicine, Aurora, CO, USA
Madiha F. Abdel-Maksoud: Department of Epidemiology, Colorado School of Public Health, Aurora, CO, USA
Colleen K. McIlvennan: Division of Cardiology, Department of Medicine, University of Colorado School of Medicine, Aurora, CO, USA
Daniel D. Matlock: Adult and Child Consortium for Health Outcomes Research and Delivery Science, University of Colorado School of Medicine, Aurora, CO, USA

Medical Decision Making, 2018, vol. 38, issue 5, 584-592

Abstract: Background. Unrestrained use of expensive, high-risk interventions runs counter to the idea of a limited medical commons. Objective. To examine the effect of displaying the total first-year cost of implanting a left ventricular assist device (LVAD) on a hypothetical treatment decision and whether this effect differs when choosing for oneself versus for another person. Design. We conducted an online survey in February 2016. The survey described the clinical course of end-stage heart failure and the risks and benefits of an LVAD. Participants were randomized to 1 of 4 scenarios, which varied by patient identity (oneself versus another person) and description of total cost. Measurements. This study measured acceptance of LVAD implantation. Reasoning and attitudes were secondarily explored. Results. We received 1211 valid responses. The mean age was 38.3 y (±12.8); 53.5% were female and 84.4% were white. Participants were more likely to accept an LVAD when shown the total cost (66.2% v. 58.0%, P = 0.003) or when choosing for another (68.0 % v. 56.4%, P

Keywords: decision aids; end-of-life care; ethics; health care costs; patient decision making; preferences; quality of life (search for similar items in EconPapers)
Date: 2018
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Citations: View citations in EconPapers (1)

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Persistent link: https://EconPapers.repec.org/RePEc:sae:medema:v:38:y:2018:i:5:p:584-592

DOI: 10.1177/0272989X18773718

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