title: Predictors of hospitalised patients' preferences for physician-directed medical decision-making.
abstract: BACKGROUND
  Although medical ethicists and educators emphasise patient-centred decision-making, previous studies suggest that patients often prefer their doctors to make the clinical decisions.
  
  
  OBJECTIVE
  To examine the associations between a preference for physician-directed decision-making and patient health status and sociodemographic characteristics.
  
  
  METHODS
  Sociodemographic and clinical information from all consenting general internal medicine patients at the University of Chicago Medical Center were examined. The primary objectives were to (1) assess the extent to which patients prefer an active role in clinical decision-making, and (2) determine whether religious service attendance, the importance of religion, self-rated spirituality, Charlson Comorbidity Index, self-reported health, Vulnerable Elder Score and several demographic characteristics were associated with these preferences.
  
  
  RESULTS
  Data were collected from 8308 of 11,620 possible participants. Ninety-seven per cent of respondents wanted doctors to offer them choices and to consider their opinions. However, two out of three (67%) preferred to leave medical decisions to the doctor. In multiple regression analyses, preferring to leave decisions to the doctor was associated with older age (per year, OR=1.019, 95% CI 1.003 to 1.036) and frequently attending religious services (OR=1.5, 95% CI 1.1 to 2.1, compared with never), and it was inversely associated with female sex (OR=0.6, 95% CI 0.5 to 0.8), university education (OR=0.6, 95% CI 0.4 to 0.9, compared with no high school diploma) and poor health (OR=0.6, 95% CI 0.3 to 0.9).
  
  
  CONCLUSIONS
  Almost all patients want doctors to offer them choices and to consider their opinions, but most prefer to leave medical decisions to the doctor. Patients who are male, less educated, more religious and healthier are more likely to want to leave decisions to their doctors, but effects are small.
authors.affiliation: The University of Chicago, 5841 S Maryland Avenue, Chicago, IL 60637, USA.
authors.forename: Grace S
authors.initials: GS
authors.lastname: Chung
authors.forename: Ryan E
authors.initials: RE
authors.lastname: Lawrence
authors.forename: Farr A
authors.initials: FA
authors.lastname: Curlin
authors.forename: Vineet
authors.initials: V
authors.lastname: Arora
authors.forename: David O
authors.initials: DO
authors.lastname: Meltzer
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D001294:Attitude to Health; D003430:Cross-Sectional Studies; D003625:Data Collection; D003657:Decision Making; D004522:Educational Status; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010358:Patient Participation / Q000523:psychology*; D057240:Patient Preference / Q000523:psychology / Q000706:statistics & numerical data*; D018802:Patient-Centered Care; D010817:Physician-Patient Relations; D012067:Religion; D029181:Spirituality