Clinical and Cost-Effectiveness of Shared Decision Making: Evidence from a Prospective Multicenter Study Evaluating a Hospital-Based Intervention in Germany

Marie Barzen Coors, Fülöp Scheibler, Jens U. Rüffer, Kai Wehkamp, Udo Schneider, Wiebke Schüttig, Friedemann Geiger and Leonie Sundmacher
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Marie Barzen Coors: Department of Health Economics, TUM School of Medicine and Health, Technical University of Munich, Munich, BY, Germany
Fülöp Scheibler: National Competency Center for Shared Decision Making, University Hospital Schleswig-Holstein, Kiel, SH, Germany
Jens U. Rüffer: TAKEPART Media + Science GmbH, Cologne, NRW, Germany
Kai Wehkamp: ISPP Institute for Safety of Patients and Health Professionals, MSH Medical School, Hamburg, HH, Germany
Udo Schneider: Health Services Management, Techniker Krankenkasse, Hamburg, HH, Germany
Wiebke Schüttig: Department of Health Economics, TUM School of Medicine and Health, Technical University of Munich, Munich, BY, Germany
Friedemann Geiger: National Competency Center for Shared Decision Making, University Hospital Schleswig-Holstein, Kiel, SH, Germany
Leonie Sundmacher: Department of Health Economics, TUM School of Medicine and Health, Technical University of Munich, Munich, BY, Germany

Medical Decision Making, 2026, vol. 46, issue 6, 795-809

Abstract: Objective To evaluate the clinical and cost-effectiveness of SHARE TO CARE (S2C), a complex intervention for hospital-wide, systematic implementation of shared decision making. Methods We analyzed clinical effectiveness, health care resource utilization, and implementation costs of S2C from the statutory health insurance perspective using a quasi-experimental difference-in-differences approach with evidence from the Department of Neurology. Clinical outcomes included inpatient hospital admissions, emergency department admissions, and rates of standard and advanced imaging procedures. Implementation costs comprised those related to the conception, development, process integration, ongoing support, and auditing of S2C. Health care utilization data covered inpatient and outpatient care, pharmaceuticals, therapeutic services, assistive devices, and nursing care. We conducted sensitivity analyses to account for uncertainties. Findings S2C was associated with a reduction in inpatient hospital admissions, emergency department admissions, and imaging rates in the intervention group. The cost analyses aligned with these findings, showing reduced total costs and health care resource utilization in the intervention group. Although none of the estimates reached the predefined thresholds for statistical significance, the primary analysis yielded weak evidence ( P  

Keywords: shared decision making; healthcare innovation; health policy; health economics; cost effectiveness (search for similar items in EconPapers)
Date: 2026
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Persistent link: https://EconPapers.repec.org/RePEc:sae:medema:v:46:y:2026:i:6:p:795-809

DOI: 10.1177/0272989X261450971

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