PDF(Pubmed)
Abstract：
Direct and indirect costs of care influence patients\' health choices and the ability to implement those choices. Despite the significant impact of care costs on patients\' health and daily lives, patient decision aid (PtDA) and shared decision-making (SDM) guidelines almost never mention a discussion of costs of treatment options as part of minimum standards or quality criteria. Given the growing study of the impact of costs in health decisions and the rising costs of care more broadly, in fall 2021 we organized a symposium at the Society for Medical Decision Making\'s annual meeting. The focus was on the role of cost information in PtDAs and SDM. Panelists gave an overview of work in this space at this virtual meeting, and attendees engaged in rich discussion with the panelists about the state of the problem as well as ideas and challenges in incorporating cost-related issues into routine care. This article summarizes and extends our discussion based on the literature in this area and calls for action. We recommend that PtDA and SDM guidelines routinely include a discussion of direct and indirect care costs and that researchers measure the frequency, quality, and response to this information.
摘要：
护理的直接和间接成本会影响患者的健康选择以及实施这些选择的能力。尽管护理费用对患者的健康和日常生活有重大影响，患者决策辅助(PtDA)和共享决策(SDM)指南几乎从未提及将治疗方案的成本作为最低标准或质量标准的一部分进行讨论.鉴于越来越多的研究表明医疗决策成本的影响以及医疗成本的不断上升，2021年秋季，我们在医疗决策协会的年会上组织了一次研讨会。重点是成本信息在PtDA和SDM中的作用。小组成员在这个虚拟会议上概述了这个领域的工作，与会者与小组成员就问题的状态以及将成本相关问题纳入日常护理的想法和挑战进行了丰富的讨论。本文根据该领域的文献总结并扩展了我们的讨论，并呼吁采取行动。我们建议PtDA和SDM指南通常包括对直接和间接护理成本的讨论，并建议研究人员测量频率，质量,并对这些信息做出回应。
