Study: More Empowered Patients Can Mean Higher Medical Costs

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Does this mean we can’t have it both ways? As patients, we’d like more say in our medical care. We’d also like the astronomical costs of care to come down. But here’s the Los Angeles Times headline: Patients who helped with medical choices had higher bills: study.

The story describes a study just out in the journal JAMA Internal Medicine that found that involving patients more in medical decisions can lead to longer hospital stays and higher costs — quite a bit higher.  (See the journal’s video interview with the author here.) The numbers:

Analyzing the data, the researchers found that nearly all — 96.3% — wanted to receive information about their illnesses and treatment options, but that only 28.9% said they had a strong preference for making their own decisions about their care.

Those patients had longer hospital stays, by about a quarter of a day on average, than patients who preferred let their doctors take the lead. They also had greater hospital costs ($865 more, on average.) By and large, people who were more likely to participate in medical decisions were better educated, and more likely to have private insurance coverage, than the rest of the patients who were surveyed.

To put the finding in perspective, the team calculated that multiplying the 28.9% of patients by the 35 million hospitalizations in the U.S. each year yielded 10 million hospitalizations. If each represented an additional quarter of a day and $865, the impact would total 2.6 million hospital days and about $8.7 billion in costs.

Ouch. Readers? Is it still the right thing to do? Is there some way to have it both ways?

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  • Rob Halkes

    We keep on puzzling on contradictory perceptions and research data.First
    of all study the data well! Look at their sources, than think: when we
    tap more into patients’ personal thoughts and emotions, it might reveal
    that there is a world to discover that was not formerly disclosed to
    (formal) care providers. It might mean that we are all “whole” humans
    with a natural and self evident interplay between mind and body. We are
    only beginning to ascertain what effects this (should) has (have) on
    caring….

  • John Sung Kim

    One thing I’d be curious about is how those patients who were less involved with their medical decisions did in the medium to long run. Were they readmitted? Meaning, even though the active patients stayed a 1/4 of a day longer, was the readmission rate for them 25% lower? Stats could tell any story – any story the authors want. Or as my old math professor used to say, “The best liars use statistics.”

    • moshimi-bill

      Waiting for the part where you pitch doctorbase.com….

  • Amanda Griffith

    I think it depends on your relationship with your doctor. As someone now struggling with infertility and after living with ulcerative colitis for 20+ years, you bet I want to take an active role in my care. After a miscarriage, MRSA and an ectopic pregnancy, I want to be happy and healthy and if tests are required – or hospitalizations – to do it, I trust that my doctor will listen to my concerns and create a treatment plan that’s practical and realistic. If it costs a little more, at least I’ll be healthy and a healthy me equals a more productive me.