PhD conferral Ms Adriana E.M. Brabers, MSc.

“Patient involvement and medical practice variation; can patients be ignored in theories about practice variation?”

Keywords: medical practice variation, joint decision-making, patient involvement

Patients are expected to be actively involved in medical decision-making. This dissertation explored the mechanisms explaining patient involvement in medical decision-making. Social support and social standards, among other things, were shown to play a role in this, which means that the decision to participate in the decision-making process is less individually based than one might think. This dissertation also examined the effects of patient involvement on decision-making and medical practice variation, i.e. similar patients not receiving the same treatment. Scientific literature suggests that patient involvement can result in less variation. The findings of this dissertation confirmed this hypothesis. We found that joint decision-making results in less inter-hospital variation.