Book Description

This report, a collaborative project with the Informed Medical Decisions Foundation, looks at the variation in surgical rates in 306 hospital referral regions across the United States (a hospital referral region is a large health care market containing at least one referral hospital). In the Appendix, patients can find the rates for ten different surgical procedures and one test in 12 different hospital referral regions and 166 hospital service areas in the New England region (a hospital service area encompasses the geographic area served by a relatively small number of hospitals). Other editions will look at variation in the rates of these procedures in other regions. Data for the entire nation, encompassing more than 3,400 hospital service areas, can be found on the Dartmouth Atlas web site (www.dartmouthatlas.org).This report is divided into three parts. The first section, "The Importance of Choice in Health Care," explains the concept of shared decision-making, a process that helps patients understand their choices fully and allows them to share treatment decisions with their clinicians. The second section, "Variation in Preference-Sensitive Care," briefly describes the treatment choices facing patients with eight different conditions, all of which can--but do not have to be--treated with surgery. The last section, "Ensuring Patients Get the Care They Need and Want," discusses steps patients can take to make sure they get the care they want and need. It also discusses how physicians and other clinicians can support shared decision-making to ensure that patients make fully informed choices. When done right, shared decision-making results in a better decision: a personalized choice based on the best scientific evidence and the patient's own values.