Analysis of Out-of-Pocket Cost of Lung Cancer Screening for Uninsured Patients Among ACR-Accredited Imaging Centers
Analysis of Out-of-Pocket Cost of Lung Cancer Screening for Uninsured Patients Among ACR-Accredited Imaging Centers
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DOI：
10.1016/j.jacr.2020.03.001
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发表时间：
2020-09-01
影响因子：
4.5
通讯作者：
Flores, Efren J.
中科院分区：
文献类型：
--
作者：
Febbo, Jennifer;Little, Brent;Flores, Efren J.
目的：为了确定的变化，自付费用的肺癌筛查（LCS）为无保险的患者，并评估此信息通过电话或Internet.Methods的可访问性：LCS中心从ACR的LCS数据库中随机选择。2019年7月至8月期间致电中心以确定自付费用。获得了电话变量、筛查中心网站上费用信息的可访问性、筛查中心的收费管理员以及公共设施和国家保险覆盖变量。使用描述性分析总结了成本信息。进行了多变量线性回归分析，以评估设施和州级特征对自付费用的影响。结果：纳入了55个经ACR认证的LCS中心，其中78%（55个中的43个）愿意提供自付费用。平均自付费用为583美元+/-607美元（平均值+/-标准差），范围为49美元至2409美元。平均电话通话时间为6 +/- 3.8分钟。55个筛查中心的网站中有2个提供了自付费用信息，1个通过电话提供了匹配费用。在55个筛查中心中，有30个发现了充电器。没有统计学上的显着差异，在自付费用被发现的地理区域，国家百分比的无保险居民，国家百分比的居民与公共保险，或设施安全网hospital affiliation.Discussion：自付LCS费用为无保险的患者和可用性的这一信息是高度可变的。放射学实践应该意识到这种可能影响未投保患者参与率的变化。
Purpose: To determine the variability in out-of-pocket costs of lung cancer screening (LCS) for uninsured patients and assess accessibility of this information by telephone or Internet.Methods: LCS centers from the ACR's LCS database were randomly selected. Centers were called between July and August 2019 to determine out-of-pocket cost. Telephone call variables, accessibility of cost information on screening centers' websites, screening centers' chargemasters, and publicly available facility and state insurance coverage variables were obtained. Cost information was summarized using descriptive analyses. Multiple variable linear regression analyses were conducted to evaluate effects of facility and state-level characteristics on out-of-pocket costs.Results: Fifty-five ACR-accredited LCS centers were included with 78% (43 of 55) willing to provide out-of-pocket cost. Average outof-pocket cost was $583 +/- $607 (mean +/- standard deviation), range $49 to $2,409. Average telephone call length 6 +/- 3.8 min. Two of fifty-five screening centers' websites provided out-of-pocket cost information, and one matched cost given over the telephone. A chargemaster was found for 30 of 55 screening centers. No statistically significant differences in out-of-pocket costs were found by geographic region, state percentages of uninsured residents, state percentages of residents with public insurance, or facility safety net hospital affiliation.Discussion: Out-of-pocket LCS costs for uninsured patients and availability of this information is highly variable. Radiology practices should be aware of this variability that may influence participation rates among uninsured patients.