PURPOSE: In 2004 healthcare costs in the US were 14% of the GDP. The US spends more on healthcare than any other country yet outcomes are not superior to others spending less. Many complex issues contribute to this high cost including fee for service, a demand market and high technology. Physicians are among the drivers of costs, yet physician knowledge of costs may be poor. Disease management focuses on implementing evidence-based therapy that contributes to quality improvement and cost effectiveness. We sought to determine the knowledge of physicians, house officers and medical students of perceived costs of common, mostly cardiopulmonary, diagnostic and therapeutic interventions compared to actual hospital charges and Medicare payments.
METHODS: A standard survey questionnaire was randomly distributed to faculty, residents and house officers who practice in the 8 Louisiana public safety net hospital system. A total of 198 responses were completed. House officers represented LSU, Ochsner and Tulane training programs. Medical students included LSU, Tulane and out of state students. The survey included 15 questions divided into laboratory tests, radiology tests, EKG, and commonly prescribed medications. Costs were divided into hospital charges not including physician interpretation charges and Medicare payment for services. Results of survey are reported as median response in dollars for all participants.
RESULTS: The median response was statistically different from the actual value on 50% of the items for hospital charges and on 87.5% of the items for Medicare payment. Median responses were compared across three groups of respondents: staff, residents, and students, but for each item median response did not differ across the groups. Within each group, however, there was considerable variability in response.
CONCLUSION: There was tremendous variability in medical personnel’s perceptions of costs. Median perception of cost generally differed from the actual cost. There were no statistically significant differences in the median perceptions across the 3 groups of responders.
CLINICAL IMPLICATIONS: It is unknown what impact instructions on cost would have on the overall healthcare costs. This is certainly a field for further study.
DISCLOSURE: Lee Arcement, None.