PDB70 - Shared Decision Making and Satisfaction with Care Among Patients with Diabetes Mellitus

Abstract

Shared decision-making (SDM) improves satisfaction with care which is associated with treatment adherence and preventive care use behaviors important in diabetes care management. Literature examining association between SDM and satisfaction with care among patients with diabetes is limited. We examined association between SDM and satisfaction with care among patients with diabetes in a national sample. A retrospective cohort study was conducted using 2013 – 2015 Medical Expenditure Panel Survey (MEPS) data. The sample consisted of adults (18 years old or older) with diabetes who had a usual source of care and had no cognitive limitation. SDM was measured using seven MEPS questionnaire items. SDM was coded as a binary variable: “high involvement” defined as complete agreement on all seven items, or “less than high involvement” defined as incomplete agreement on any of the seven items. Satisfaction with care was measured using a single item in MEPS, approximately 9 months after shared decision-making was measured. Satisfaction with care was coded as a binary variable: “complete satisfaction” if patients rated care as “best healthcare,” or “incomplete satisfaction” if patients rated care any less than “best healthcare.” Multiple logistic regression estimated association between shared decision-making and satisfaction with care controlling for socio-economic status, perceived health status, and diabetes disease duration. SAS version 9.4 was used for analysis with an a priori alpha of 0.05. Respondents (n = 486) were mostly female (58%), non-Hispanic white (69%), had high school or less education (38%), and had mean (standard deviation) age of 59.6 year (12.9) old. Overall, 42% reported complete satisfaction with care. Diabetes patients who had high involvement in shared decision-making were four times more likely to report complete satisfaction with care (O.R = 4.06, p < 0.0001). Shared decision making was associated with increased likelihood of complete satisfaction with care.