美国成年人患者感知的共享决策模式趋势，2002-2014 年。
Trends in Patient-Perceived Shared Decision Making Among Adults in the United States, 2002-2014.
机构信息
Division of General Internal Medicine and Primary Care, Brigham and Women's Hospital, Boston, Massachusetts
Harvard Medical School, Boston, Massachusetts.
出版信息
Ann Fam Med. 2017 Nov;15(6):552-556. doi: 10.1370/afm.2132.
Abstract
To ascertain changes in shared decision making (SDM), we analyzed data from the nationally representative Medical Expenditure Panel Survey. We aggregated responses to questions into a 7-point SDM composite score. Between 2002 and 2014, the mean SDM composite score increased from 4.4 to 5.0 ( <.01), indicating greater patient-perceived SDM. In multivariate modeling, SDM scores were higher for black vs white patients (+0.33 points) and those with a same-race/ethnicity usual source of care (+0.24 points; both P <.05). Scores were lower for patients with poor-perceived health (-0.41 points), Asian vs white race/ethnicity (-0.28 points), and no insurance (-0.17 points; all P <.05). Improvement efforts should target Americans without a same-race/ethnicity usual source of care and with poor-perceived health.
摘要
为了确定共享决策制定（SDM）的变化，我们分析了来自全国代表性的医疗支出调查的数据。我们将问题的回答汇总成一个 7 分的 SDM 综合评分。在 2002 年至 2014 年期间，SDM 综合评分从 4.4 增加到 5.0（<.01），表明患者对 SDM 的感知程度更高。在多变量模型中，黑人患者与白人患者相比（+0.33 分）和与同一种族/族裔的常规护理来源相比（+0.24 分；均<.05），SDM 评分更高。对于健康状况较差的患者（-0.41 分）、亚裔患者与白人种族/族裔相比（-0.28 分）和没有保险的患者（-0.17 分；均<.05），评分较低。改进措施应针对没有同一种族/族裔常规护理来源和健康状况较差的美国人。
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