Public Information and Private Search: Evaluating the Patient Self-Determination Act
Bradley, Elizabeth H.
Rizzo, John A.
Journal of Health Politics, Policy and Law. 1999 Apr; 24(2): 239-273.
Despite substantial regulatory efforts to improve consumer information regarding health and health care, little is known about the impact of such efforts on consumer behavior. This article examines the effect of federal legislation to enhance consumer information regarding the use of life-sustaining technology in end-of-life medical treatment decision making. Using a unique set of data abstracted from the medical records of six hundred elderly patients in nursing homes, the study finds a substantial impact of the law in promoting improved documentation of patient wishes for end-of-life medical care. Further, the data reveal that the effect of the law varies among identifiable subgroups. Consistent with the theory of search, the article demonstrates that the effects of regulatory efforts that promote the public provision of consumer information are greatest among individuals for whom information is most beneficial but for whom private search is costly. Implications for health policy are discussed.
Advance Directives; Age Factors; Decision Making; Education; Empirical Research; Evaluation; Evaluation Studies; Females; Health; Health Care; Health Insurance; Incentives; Information Dissemination; Insurance; Law; Legislation; Life; Males; Medical Records; Morbidity; Nursing Homes; Patient Admission; Patients; Records; Research; Social Impact; Socioeconomic Factors; Statistics; Technology;
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Assessing Capacity to Participate in Discussions of Advance Directives in Nursing Homes: Findings From a Study of the Patient Self-Determination Act Bradley, Elizabeth; Walker, Leslie; Blechner, Barbara; Wetle, Terrie (1997-01)OBJECTIVE: To better understand the implementation of the Patient Self-Determination Act (PSDA) in long-term care, with a focus on the informing process as it affects advance directives. DESIGN: Retrospective cohort study of ...