Health systems across Canada have made the advancement of health equity a priority. Addressing patients’ specific needs and involving them in decisions about their care and treatment can help reduce health inequalities and lead to better outcomes.
You have to be working together. And you have to be working with patients and you have to be working with families. They’re all part of the team. I felt that they were disconnected. I felt that you had to be your own advocate. And I’m a tried-and-true believer of being your own health care advocate because if you don’t, you may end up far worse than I did.— Roger, Patient, New Brunswick
Involvement in Decision-Making and Treatment Options is a patient-reported experience measure (PREM) that provides information on whether patients were involved as much as they wanted to be in decisions about their care and treatment, and whether their friends and family were involved as much as the patient wanted them to be. Ensuring that patients have appropriate information on their diagnosis and treatment and are involved in decision-making is essential for providing safe, equitable and quality care.
Involvement in Decision-Making and Treatment Options
55% of patients said that their own or their friends’ and family’s involvement in decisions about their care and treatment was very good.
| Province | Poor | Good | Very good | Number of respondents | |
|---|---|---|---|---|---|
|
Nova Scotia |
5% |
29% |
66% |
2,873 |
|
|
New Brunswick |
6% |
32% |
61% |
5,931 |
|
|
Ontario |
12% |
33% |
55% |
44,168 |
|
|
Manitoba |
15% |
32% |
52% |
10,835 |
|
|
Alberta |
10% |
34% |
56% |
21,294 |
|
Note
Data is shown for the most recent year of data submission (Ontario, Manitoba and Alberta, 2020–2021; New Brunswick, 2018–2019; Nova Scotia, 2017–2018).
Nationally, Involvement in Decision-Making and Treatment Options had the lowest proportion of patients reporting the most positive response compared with the other 4 publicly reported PREMs in this release.
Of the PREMs in this release, this measure was the only one that declined between 2019–2020 and 2020–2021; this decrease may be due to the impact of COVID-19 on patient experience in acute care hospitals.
You can explore your hospital results in the Your Health System: In Depth interactive web tool, alongside other measures of hospital performance. Details about Involvement in Decision-Making and Treatment Options can be found on CIHI’s Indicators web page.
What other patient experience measures are strongly associated with this measure?
The following 3 key drivers have been identified for the Involvement in Decision-Making and Treatment Options measure. A key driver is a patient experience measure that is strongly associated with or that influences results for this measure. Key drivers can potentially be used as areas of focus when planning quality improvement initiatives.
For more information on the methodology used in the key drivers analysis, please see Acute Care Patient-Reported Experience Measures — Methodology Notes. To learn more about CIHI’s other PREMs, see the Canadian Patient Experiences Survey — Inpatient Care: Patient-Reported Experience Measures.
Key drivers: Involvement in Decision-Making and Treatment Options
Emotional Support
Whether patients felt they were supported and helped with any anxieties, fears or worries during their hospital stay.
Received Information About Condition and Treatment
Whether patients felt they received all of the information they needed about their condition and treatment.
Internal Coordination of Care
Whether patients felt there was good communication between doctors, nurses and other hospital staff. This measure also looks at whether patients felt that hospital staff seemed informed about and up to date on their hospital care.
Digging deeper: PREMs and the value of socio-demographic information
How does patient experience differ across socio-demographic groups?
Hospitals across Canada serve diverse communities with various needs. To support understanding and ensure equitable care in these populations, CIHI’s Canadian Patient Experiences Survey — Inpatient Care (CPES-IC) collects information on several socio-demographic variables, including age, recorded sex or gender, race/ethnicity and education.
Note
* Percentages do not add up to 100% due to rounding.
Note
* Due to limitations in the current CPES-IC, gender is considered accurate for only the cisgender population (i.e., those whose sex at birth aligns with their gender identity). Work is underway to expand collection of gender identities beyond the binary.
| Racialized group | Percentage of respondents | Number of respondents |
|---|---|---|
|
White |
79% |
294,927 |
|
Unknown |
6% |
23,679 |
|
East Asian |
4% |
15,507 |
|
Another |
3% |
12,942 |
|
South Asian |
3% |
11,845 |
|
Black |
2% |
7,701 |
|
Middle Eastern |
1% |
3,812 |
|
Latin American |
1% |
3,345 |
|
First Nations, Inuit and Métis Peoples |
Less than 1% |
1,491 |
Note
* Results for First Nations, Inuit and Métis Peoples can be requested, with permission from Indigenous authorities, in keeping with CIHI’s policy.
Exploring patient experiences by different socio-demographic variables can uncover gaps in care and inform tailored programs and services to support an equitable care experience for all patients. For example, while there is little difference between age groups in terms of how they feel about their friends’ and family’s involvement, older patients feel that they themselves are less involved in decision-making and treatment options compared with younger patients. The size of this gap may vary depending on cultural and language differences between patients and care providers; this is important because patient and family involvement is connected to safer, higher-quality care.
Percentage of patients responding they were involved as much as they wanted in decisions about their care and treatment, by age and racialized group
| Racialized group | Age group (in years) 18–59 | Age group (in years) 60–79 | Age group (in years) 80+ |
|---|---|---|---|
|
Another |
59% |
56% |
49% |
|
Black |
59% |
53% |
47% |
|
East Asian |
58% |
51% |
41% |
|
Middle Eastern |
59% |
53% |
42% |
|
South Asian |
59% |
52% |
42% |
|
White |
61% |
57% |
48% |
Notes
Data is shown for all provinces and years of available data (2015 to 2021).
Data from Latin American respondents is suppressed due to small numbers.
Results for First Nations, Inuit and Métis Peoples can be requested, with permission from Indigenous authorities, in keeping with CIHI’s policy.
Percentage of patients responding that their family and friends were involved as much as they wanted in decisions about their care and treatment, by age and racialized group.
| Racialized group | Age group (in years) 18–59 | Age group (in years) 60–79 | Age group (in years) 80+ |
|---|---|---|---|
|
Another |
64% |
67% |
69% |
|
Black |
64% |
65% |
73% |
|
East Asian |
63% |
65% |
69% |
|
Middle Eastern |
64% |
66% |
74% |
|
South Asian |
65% |
66% |
68% |
|
White |
66% |
66% |
68% |
Notes
Data is shown for all provinces and years of available data (2015 to 2021).
Data from Latin American respondents is suppressed due to small numbers.
Results for First Nations, Inuit and Métis Peoples can be requested, with permission from Indigenous authorities, in keeping with CIHI’s policy.
The results presented above demonstrate broad, national trends using all available years of data; however, you may find different relationships among the communities you serve. Given the small proportion of respondents in some racialized groups, caution should be taken when interpreting differences between groups. Nevertheless, the socio-demographic information collected from the CPES-IC can uncover new opportunities to improve patient experiences by minimizing health inequalities. For more information on health inequalities, please visit CIHI’s Health equity and population health web page.
Related resources
- Impact of COVID-19 on patient experience in acute care hospitals
- Your Health System: In Depth web tool
- Canadian Patient Experiences Survey — Inpatient Care: Patient-Reported Experience Measures (PDF)
- Methodology notes (PDF)
- A Path Forward: Toward Respectful Governance of First Nations, Inuit and Métis Data Housed at CIHI (PDF)
- Health equity and population health
- Indicators web page (definitions and methodologies for CIHI’s indicators)