Medical Decision Making

How health professionals and patients make treatment decisions, and the barriers to, and facilitators of, effective decision making.

Measuring Emergency Care Survival: The Implications of Risk-Adjusting for Race and Poverty

Jun. 20, 2018

Kimon L.H. Ioannides, Avi Baehr, David N. Karp, Douglas J. Wiebe, Brendan G. Carr,...

ABSTRACT [FROM JOURNAL]

Objectives: We determined the impact of including race, ethnicity, and poverty in risk adjustment models for emergency care sensitive conditions mortality that could be used for hospital pay‐for‐performance initiatives. We hypothesized that adjusting for race, ethnicity, and poverty would bolster rankings for hospitals that cared for a disproportionate share of non‐white, Hispanic, or poor patients.

Methods: We performed a cross‐sectional analysis

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When Physicians Support Financial Penalties to Reduce Low-Value Care (and When They Don’t)

Dec. 16, 2017

Despite professional consensus, guidelines, and national campaigns, physicians continue to provide many low-value services. These services are defined as having little to no benefit, little benefit relative to their cost, or outsized potential harm compared to their benefit. Policies have tried to promote high-value care by altering physician compensation, but have had limited success in part because they are rarely based on theories of physician behavior.

Will Decision Aids Save Money?

Jun. 28, 2017

Where you end up may depend on where you start. That’s the perspective taken by LDI Senior Fellow Said Ibrahim in the New England Journal of Medicine, as he discusses how shared decision-making tools and increased patient knowledge affect treatment choice. Specifically, Ibrahim looks at elective joint replacement, and examines how increased use of decision aids affects the choice to pursue either conservative management or total joint replacement.

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