Barriers to patient-physician communication about out-of-pocket costs
Barriers to patient-physician communication about out-of-pocket costs
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DOI：
10.1111/j.1525-1497.2004.30249.x
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发表时间：
2004-08-01
影响因子：
5.7
通讯作者：
Meltzer, DO
中科院分区：
文献类型：
--
作者：
Alexander, GC;Casalino, LP;Meltzer, DO
背景：虽然许多患者和医生认为他们应该讨论自付费用，但研究表明他们很少这样做。 目的：检查研究对象之间关于自付费用的沟通障碍，回顾他们想讨论这些费用但没有这样做的时间。 设计、设置和参与者：对来自 3 个国家的 133 名普通内科医生和 484 名患者进行横断面调查中西部大都市地区的学术和 18 个社区实践。测量：患者和医生报告讨论自付费用的障碍。主要结果：总体而言，54 名患者 (11%) 和 27 名医生 (20%) 能够回忆起他们想要讨论自付费用但没有这样做的特定时间。在患者中，报告了各种各样的障碍，包括他们自己的不适（19%）、时间不足（13%）、认为他们的医生没有可行的解决方案（11%）以及担心讨论对护理质量的影响（9%）。在医生中，最常见的障碍是时间不足（67%）和认为自己无法提供解决方案（19%）。结论：促进自付费用讨论的努力应强调患者担忧的合理性以及医生可以采取的简短可行的替代方案来解决这些问题。
BACKGROUND: Though many patients and physicians believe that they should discuss out-of-pocket costs, research suggests that they infrequently do.OBJECTIVES: To examine barriers preventing patient-physician communication about out-of-pocket costs among study subjects recalling a time when they wanted to discuss these costs but did not do so.DESIGN, SETTING, AND PARTICIPANTS: Cross-sectional surveys of 133 general internists and 484 of their patients from 3 academic and 18 community practices in a large midwestern metropolitan region.MEASUREMENTS: Patient- and physician-reported barriers to discussing out-of-pocket costs.MAIN RESULTS: Overall, 54 patients (11%) and 27 physicians (20%) were able to recall a specific time when they wanted to discuss out-of-pocket costs but did not do so. Among patients, a wide variety of barriers were reported including their own discomfort (19%), insufficient time (13%), a belief that their physician did not have a viable solution (11%), and concerns about the impact of discussions on quality of care (9%). Among physicians, the most common barriers reported were insufficient time (67%) and a belief that they did not have a solution to offer (19%).CONCLUSIONS: Efforts to promote discussions of out-of-pocket costs should emphasize the legitimacy of patients' concerns and brief actionable alternatives that physicians can take to address them.