Construction of a Shared Decision-Making Model Between Doctor and Patient in China Based on Selection Preferences

Abstract

Influenced by Confucian values, China’s medical decision-making emphasizes a family-centric and harmonious approach, contrasting with Western practices that highlight individual autonomy. However, there’s a global shift towards “patient-centered” care, promoting shared decision-making (SDM) between healthcare practitioners and patients. This study aims to advance the SDM model in China by analyzing the alignment in decision-making between doctors and patients. The focus is on addressing the absence of quantitative tools for SDM coordination. An SDM coupling coordination model was developed, and the coordination level was assessed using data from questionnaires filled by 210 doctors and 248 patients from three prominent Chinese hospitals. Doctors’ and patients’ preferences were categorized into four areas: treatment efficacy, cost considerations, potential side effects, and overall treatment experience. The coordination degrees, represented by “D values,” for these areas were 0.6375, 0.5299, 0.5704, and 0.4586, respectively. A higher “D value” signifies better alignment between doctors and patients. Treatment efficacy showed the strongest alignment, followed by costs and side effects, while treatment experience had the least alignment. In conclusion, the alignment in doctor–patient SDM in China is currently not optimal. Improvements necessitate a foundational “patient-first” approach in SDM, an emphasis on optimization in collaborative strategies, and the establishment of a comprehensive platform for collaboration and coordination in SDM.