Evaluating physician awareness of common health care costs in the emergency department
Evaluating physician awareness of common health care costs in the emergency department
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DOI：
10.1017/cem.2017.43
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发表时间：
2018-07-01
影响因子：
2.4
通讯作者：
Malik, Ranjeeta
中科院分区：
文献类型：
--
作者：
Gandhi, Rohit;Stiell, Ian;Malik, Ranjeeta
背景：加拿大的医疗保健费用正在上升，我们的医疗保健系统的可持续性面临风险。作为病人护理的守门人，急诊科（艾德）医生对医疗保健费用有直接影响。我们的目的是确定当前水平的成本意识之间的艾德医生。通过了解目前的水平，医生的成本意识，我们希望确定成本教育将提供最大的好处，在减少ordering costs.Methods：我们进行了一项调查，评估目前的认识，常见的订购成本之间的艾德医生从两个三级教学医院。我们的研究人群包括124名经认证的急诊医学工作人员医生和急诊医学住院医生。我们的调查要求艾德医生估计四类日常订购的41个项目的成本：成像检查，材料，实验室检查和药物。根据使用频率、具有成本效益的替代品的可得性以及被视为“低产量”的测试选择了项目。主要结果是低估，正确的估计，高估艾德费用之间的百分比艾德physics.Results：正确的成本估计之间的平均百分比艾德医师是14%，在四个排序类别。在存在成本效益的替代品的情况下，艾德医生高估了更具成本效益的项目的成本。他们也低估了低收益测试的成本。解释：艾德医生表现出有限的成本意识的共同医疗保健成本。需要进一步研究基于艾德医师对成本效益替代方案和“低产量”测试成本的认识的医院资源利用的特征。
Background: Health care costs are on the rise in Canada and the sustainability of our health care system is at risk. As gatekeepers to patient care, emergency department (ED) physicians have a direct impact on health care costs. We aimed to identify current levels of cost awareness among ED physicians. By understanding the current level of physician cost awareness, we hope to identify areas where cost education would provide the greatest benefit in reducing ordering costs.Methods: We conducted a survey evaluating current awareness of common ordering costs among ED physicians from two tertiary teaching hospitals. Our study population was comprised of 124, certified emergency medicine staff physicians and emergency medicine resident physicians. Our survey asked ED physicians to estimate the costs of 41 items across four categories of day-to-day ordering: imaging investigations, materials, laboratory tests, and pharmaceuticals. Items were selected based on frequency of use, availability of cost-effective alternatives, and tests considered to be "low yield". The primary outcome was percentages of underestimates, correct estimates, and overestimates for ED costs among ED physicians.Results: The average percentage of correct cost estimates among ED physicians was 14% across the four ordering categories. Where cost-effective alternatives exist, ED physicians overestimated the cost of the more cost-effective item. They also underestimated the cost of low-yield tests.Interpretation: ED physicians demonstrated limited cost awareness of common health care costs. Further studies that characterize utilization of hospital resources based on ED physician awareness of cost-effective alternatives and cost of "low yield" tests are needed.