The Effect of Total Cost Information on Consumer Treatment Decisions: An Experimental Survey

Medical Decision Making : an International Journal of the Society for Medical Decision Making
Regina KwonDaniel D Matlock

Abstract

Unrestrained use of expensive, high-risk interventions runs counter to the idea of a limited medical commons. To examine the effect of displaying the total first-year cost of implanting a left ventricular assist device (LVAD) on a hypothetical treatment decision and whether this effect differs when choosing for oneself versus for another person. We conducted an online survey in February 2016. The survey described the clinical course of end-stage heart failure and the risks and benefits of an LVAD. Participants were randomized to 1 of 4 scenarios, which varied by patient identity (oneself versus another person) and description of total cost. This study measured acceptance of LVAD implantation. Reasoning and attitudes were secondarily explored. We received 1211 valid responses. The mean age was 38.3 y (±12.8); 53.5% were female and 84.4% were white. Participants were more likely to accept an LVAD when shown the total cost (66.2% v. 58.0%, P = 0.003) or when choosing for another (68.0 % v. 56.4%, P < 0.001). Open-ended responses indicated that acceptors wanted to extend survival while decliners feared poor quality of life with LVAD therapy. Acceptors and decliners agreed that consumers can help lower the cost of health care, but d...Continue Reading

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Citations

Sep 14, 2019·Hand : Official Journal of the American Association for Hand Surgery·Joost T P KortleverRobin N Kamal
Oct 14, 2019·Research in Social & Administrative Pharmacy : RSAP·Vanessa BoudewynsBrian G Southwell
Aug 12, 2021·Medical Decision Making : an International Journal of the Society for Medical Decision Making·Donald A RedelmeierRobert J Tibshirani

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Methods Mentioned

BETA
coronary artery bypass

Software Mentioned

SAS
MTurk
Amazon Mechanical Turk MTurk

Related Concepts

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Artificial Heart & Ventricular Assist Devices

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