Assessing the Association of Healthcare Resource Utilization and Patient-Reported Outcomes on Shared Decision-Making among Multimorbid Individuals
Abstract
1. Introduction
2. Materials and Methods
3. Results
4. Discussion
Limitations
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
Appendix A
Patient-Reported Outcomes | Optimal Shared Decision Making | |
---|---|---|
Unadjusted OR (95% CI) | Adjusted OR (95% CI) | |
General health today | ||
Excellent/very good/good | 1.052 (0.863, 1.282) | 0.856 (0.671, 1.093) |
Fair/poor | Ref | Ref |
During a typical day, limitations in moderate activities | ||
Limited a lot/little | 0.855 (0.717, 1.020) | 1.074 (0.864, 1.335) |
Not limited | Ref | Ref |
During a typical day, limitations in climbing several flights of stairs activities | ||
Limited a lot/little | 0.801 (0.655, 0.979) * | 0.980 (0.778, 1.235) |
Not limited | Ref | Ref |
During past 4 weeks, as a result of physical health, accomplished less than would like | ||
All/most/some/little | 0.907 (0.761, 1.080) | 1.095 (0.877, 1.366) |
None | Ref | Ref |
During past 4 weeks, as a result of physical health, limited in kind of work or other activities | ||
All/most/some/little | 0.990 (0.823, 1.190) | 1.272 (1.011, 1.601) * |
None | Ref | Ref |
During past 4 weeks, as a result of emotional problems, accomplished less than would like | ||
All/most/some/little | 1.130 (0.935, 1.366) | 1.208 (0.975, 1.497) |
None | Ref | Ref |
During past 4 weeks, as a result of emotional problems, did work or other activities less carefully than usual | ||
All/most/some/little | 1.106 (0.877, 1.394) | 1.218 (0.939, 1.581) |
None | Ref | Ref |
During past 4 weeks, pain interfered with normal work outside the home and housework | ||
Little/moderate/quite a bit/extreme | 1.047 (0.868, 1.263) | 1.234 (0.999, 1.524) |
Not at all | Ref | Ref |
During the past 4 weeks, felt calm and peaceful | ||
A good bit/most/all of the time | 0.952 (0.766, 1.182) | 0.954 (0.764, 1.192) |
Some/little/none of the time | Ref | Ref |
During the past 4 weeks, had a lot of energy | ||
A good bit/most/all of the time | 0.990 (0.816, 1.202) | 0.877 (0.706, 1.090) |
Some/little/none of the time | Ref | Ref |
During the past 4 weeks, felt downhearted and blue | ||
A good bit/most/all of the time | 0.955 (0.697, 1.307) | 0.993 (0.711, 1.386) |
Some/little/none of the time | Ref | Ref |
During the past 4 weeks, physical health or emotional problems interfered with social activities | ||
All/most/some/little of the time | 1.097 (0.897, 1.341) | 1.202 (0.958, 1.507) |
None of the time | Ref | Ref |
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Variable | Description | Response Option | Score |
---|---|---|---|
DECIDE42 | Provider asks person to help make decisions between choice of treatments | Never | 0 |
Sometimes | 1 | ||
Usually | 2 | ||
Always | 3 | ||
TREATM42 | Provider usually asks about prescription medications and treatments other doctors may give them | Yes | 1 |
No | 0 | ||
EXPLOP42 | Provider presents and explains all options | Yes | 1 |
No | 0 |
Variables | Optimal Shared Decision Making Weighted % (95% CI) | Not Optimal Shared Decision Making Weighted % (95% CI) | p-Value |
---|---|---|---|
Age | |||
18–64 | 53.2 (50.3, 56.1) | 47.6 (43.5, 51.6) | 0.01 |
≥65 | 46.8 (43.9, 49.7) | 52.4 (48.4, 56.5) | |
Sex | |||
Male | 46.3 (44.3, 48.3) | 45.8 (41.9, 49.6) | 0.75 |
Female | 53.7 (51.7, 55.7) | 54.2 (50.3, 58.0) | |
Race | |||
White | 84.2 (82.1, 86.3) | 78.5 (74.2, 82.7) | <0.01 |
Other | 15.8 (13.7, 17.9) | 21.5 (17.3, 25.8) | |
Ethnicity | |||
Hispanic | 8.7 (6.8,10.6) | 7.4 (5.3, 9.5) | 0.29 |
Non-Hispanic | 91.3 (89.4, 93.2) | 92.6 (90.5, 94.7) | |
Marital status | |||
Married | 60.2 (57.8, 62.7) | 51.6 (47.5, 55.6) | <0.01 |
Other | 39.8 (37.3, 42.2) | 48.6 (44.4, 52.5) | |
Education status | |||
Up to and including high school | 37.2 (34.8, 39.7) | 48.5 (44.2, 52.7) | <0.01 |
More than high school | 62.8 (60.3, 65.2) | 51.5 (47.3, 55.8) | |
Any limitation | |||
Yes | 39.4 (36.9, 41.8) | 45.8 (41.9, 49.5) | 0.01 |
No | 60.6 (58.2, 63.1) | 54.2 (50.5, 57.9) | |
Employment status | |||
Employed | 47.6 (45.1, 50.1) | 40.3 (36.4, 44.7) | <0.01 |
Unemployed | 52.4 (49.9, 54.9) | 59.7 (55.6, 63.9) | |
Income/poverty status | |||
Poor/near poor/low | 24.4 (21.9, 26.8) | 29.0 (24.9, 33.2) | 0.03 |
Moderate/high | 75.6 (73.2, 78.0) | 70.6 (66.8, 75.1) |
Healthcare Resource Utilization Variables | ||||
---|---|---|---|---|
Office Visits (At Least One versus None) None = Ref | Outpatient Visit (At Least One versus None) None = Ref | Emergency Room Visits (At Least One versus None) None = ref | Inpatient Discharges (At Least One versus None) None = Ref | |
Optimal Shared Decision Making | ||||
Unadjusted OR (95% CI) | 1.495 (1.003, 2.228) * | 1.218 (1.021, 1.453) * | 1.396 (1.065, 1.830) * | 1.264 (0.931, 1.715) |
Adjusted OR (95% CI) | 1.348 (0.929, 1.956) | 1.227 (1.027, 1.467) * | 1.553 (1.170, 2.063) * | 1.437 (1.052, 1.963) * |
Patient-Reported Outcomes | ||
---|---|---|
Physical Health Component Summary Score (Above Median Score versus Median Score or Below) Median Score or Below = Ref | Mental Health Component Summary Score (Above Median Score versus Median Score or Below) Median Score or Below = Ref | |
Optimal Shared Decision Making | ||
Unadjusted OR (95% CI) | 1.139 (0.932, 1.391) | 0.882 (0.715, 1.087) |
Adjusted OR (95% CI) | 0.952 (0.757, 1.198) | 0.886 (0.714, 1.098) |
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Zaidi, S.H.; Axon, D.R. Assessing the Association of Healthcare Resource Utilization and Patient-Reported Outcomes on Shared Decision-Making among Multimorbid Individuals. Healthcare 2024, 12, 1709. https://doi.org/10.3390/healthcare12171709
Zaidi SH, Axon DR. Assessing the Association of Healthcare Resource Utilization and Patient-Reported Outcomes on Shared Decision-Making among Multimorbid Individuals. Healthcare. 2024; 12(17):1709. https://doi.org/10.3390/healthcare12171709
Chicago/Turabian StyleZaidi, Syeda Hina, and David Rhys Axon. 2024. "Assessing the Association of Healthcare Resource Utilization and Patient-Reported Outcomes on Shared Decision-Making among Multimorbid Individuals" Healthcare 12, no. 17: 1709. https://doi.org/10.3390/healthcare12171709
APA StyleZaidi, S. H., & Axon, D. R. (2024). Assessing the Association of Healthcare Resource Utilization and Patient-Reported Outcomes on Shared Decision-Making among Multimorbid Individuals. Healthcare, 12(17), 1709. https://doi.org/10.3390/healthcare12171709