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Physicians Often Decide Where Medicare Patients Have Surgery

Study shows nearly one-third of Medicare patients undergoing major surgery have hospital choice decided by physician

WEDNESDAY, March 21 (HealthDay News) -- Physicians serve as the decision-maker in choosing a hospital for surgical Medicare patients nearly one-third of the time, researchers report in the March issue of the Archives of Surgery.

Chad T. Wilson, M.D., and colleagues from the Department of Veterans Affairs Medical Center in White River Junction, Vt., conducted phone interviews with 510 randomly selected Medicare patients who underwent one of five elective high-risk surgeries approximately three years earlier (abdominal aneurysm repair, heart valve replacement surgery, or resections for bladder, lung or stomach cancer), to determine who made the hospital choice for these procedures.

The investigators found that 31 percent of patients reported that their physician made the choice of hospital for the procedure, while 42 percent said they shared the decision with their doctor, 22 percent made the choice themselves, and 5 percent said their family helped decide. Male patients, those in poor health, and cardiovascular patients were more likely to let their doctors decide.

"While many patients participate in the decision-making process and may desire objective information to inform their decisions, a substantial proportion of patients are not involved at all," the authors write. "Research is needed to help us understand whether patients would like a greater role in deciding where to have major surgery and, if so, how to facilitate such involvement."

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