Clinical decision-making: Patients' preferences and experiences.
OBJECTIVE
To determine the congruence between patients' preferred style of clinical decision-making and the style they usually experienced and whether this congruence was associated with socio-economic status and/or the perceived quality of care provided by the respondent's regular doctor.


METHODS
Cross-sectional survey of the American public using computer-assisted telephone interviewing.


RESULTS
Three thousand two hundred and nine interviews were completed (completion rate 72%). Sixty-two percent of respondents preferred shared decision-making, 28% preferred consumerism and 9% preferred paternalism. Seventy percent experienced their preferred style of clinical decision-making. Experiencing the preferred style was associated with high income (OR, 1.59; 95% CI, 1.16-2.16) and having a regular doctor who was perceived as providing excellent or very good care (OR, 2.39; 95% CI, 1.83-3.11).


CONCLUSIONS
Both socio-economic status and having a regular doctor whom the respondent rated highly are independently associated with patients experiencing their preferred style of clinical decision-making.


CONCLUSIONS
Systems which promote continuity of care and the development of an on-going doctor-patient relationship may promote equity in health care, by helping patients experience their preferred style of clinical decision-making.
Murray
Elizabeth
E
Department of Primary Care and Population Sciences, Royal Free and University College Medical School at University College London, Archway Campus, Highgate Hill, London N19 5LW, United Kingdom. elizabeth.murray@pcps.ucl.ac.uk
Pollack
Lance
L
White
Martha
M
Lo
Bernard
B
D000328:Adult; D000368:Aged; D000704:Analysis of Variance; D002983:Clinical Competence; D003142:Communication; D003266:Continuity of Patient Care; D003299:Cooperative Behavior; D003430:Cross-Sectional Studies; D003657:Decision Making; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007182:Income; D008875:Middle Aged; D026706:Paternalism; D010353:Patient Education as Topic / Q000458:organization & administration; D010358:Patient Participation / Q000379:methods / Q000523:psychology*; D017060:Patient Satisfaction; D010819:Physician's Role / Q000523:psychology; D010817:Physician-Patient Relations; D011787:Quality of Health Care; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires; D014481:United States