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Comment & Response
April 2014

Actual Involvement vs Preference for Involvement as an Indicator of Shared Decision Making—Reply

Author Affiliations
  • 1Section of Hospital Medicine, Department of Medicine, University of Chicago, Chicago, Illinois
  • 2School of Public Health, University of North Texas Health Science Center, Ft Worth
JAMA Intern Med. 2014;174(4):644. doi:10.1001/jamainternmed.2013.12840

In Reply Melis and colleagues comment on our finding that patient preference for involvement in decision making among hospitalized patients is associated with increased hospital length of stay and costs and note that this contradicts the expectation that greater patient engagement will reduce resource use.1 They say that preference for involvement may not be associated with actual levels of involvement. However, while preferred and actual levels of involvement may diverge, patient preference for greater involvement still tends to be positively associated with the actual level of involvement.2,3

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