title: [Patient participation in medical decision making within an integrated health care system in Germany: results of a controlled cohort study].
abstract: An integrated health care project called "Gesundes Kinzigtal" was conducted in a rural area in Germany. As part of the project, physicians were trained  and other measures were taken to enhance patient involvement in medical decision making. As part of the external evaluation, various effects regarding patient involvement in medical decision making, patient involvement and information preference, decision confidence, patient satisfaction with ambulatory care and patient quality of life were examined. The data were gathered by means of a questionnaire on an annual basis between 2007 and 2009. Effects were compared between patients who were participating in the integrated care project and two control groups. Analyses are based on the data of 1,205 patients. Over time all outcomes decreased slightly, except for information preference and physical quality of life. No statistically significant intervention effects on patient involvement in medical decision making or any other outcome variable could be found. The intensity of the training was presumably too low to establish an enduring change in the physician-patient interaction.
authors.affiliation: Abteilung für Psychiatrie und Psychotherapie, Arbeitsgruppe Klinische Epidemiologie und Versorgungsforschung, Universitätsklinikum Freiburg, Hauptstrasse 5, Freiburg, Germany. lars.hoelzel@uniklinik-freiburg.de
authors.forename: L P
authors.initials: LP
authors.lastname: Hölzel
authors.forename: M
authors.initials: M
authors.lastname: Vollmer
authors.forename: L
authors.initials: L
authors.lastname: Kriston
authors.forename: A
authors.initials: A
authors.lastname: Siegel
authors.forename: M
authors.initials: M
authors.lastname: Härter
mesh_terms: D000553:Ambulatory Care; D015331:Cohort Studies; D003142:Communication; D003657:Decision Making; D019033:Delivery of Health Care, Integrated; D004502:Education, Medical, Continuing; D005858:Germany; D006293:Health Promotion; D006801:Humans; D010353:Patient Education as Topic; D010358:Patient Participation; D017060:Patient Satisfaction; D010817:Physician-Patient Relations; D015397:Program Evaluation; D011788:Quality of Life; D012423:Rural Health