Patient involvement in medical decisions is seen as useful for all involved in the health care system; for patients, physicians, in the area of care and on the part of research, as well as for health insurance companies and health policymakers.
There are many reasons that speak in favour of a stronger implementation of patient involvement in care: The information gap between medical experts and the affected patients is closing, and patients’ knowledge is growing steadily due to the increasing availability of medical information in the media and on the Internet.
Patients have a high need for information and the majority have a desire to be involved in medical decisions.
Patient involvement can occur on three different levels:
- The micro level of patient involvement refers to the concrete treatment decision of physician, patient, and, where applicable, family members in medical consultations. Shared decision-making can be classified as belonging to this level.
- The meso level denotes structures or institutions, for instance patient counselling facilities, which foster patient involvement in medical decisions.
- On the macro level, patient involvement is understood in terms of an active exertion of influence by patients on the regulation of medical care, for example in legislative procedures or in determining the financial viability of medical measures in the statutory health insurance.