how much does it cost? physician misperception of the costs of healthcare
TRANSCRIPT
S108 Surgical Forum Abstracts J Am Coll Surg
(n¼96, 59%)were less likely (OR 0.77, p-value 0.07) than expected touse PACS (Table).
CONCLUSIONS: Variation in use of PACS after colectomy is not
fully explained by differences in preoperative risk factors or inpa-tient complications. Given the high cost of PACS, further investi-gation into the etiology of variation is needed.
How Much Does It Cost? Physician Misperception of theCosts of HealthcareNnaemeka M Ndubisi, Swapnil D Kachare, MD, MBA, BenjaminS Robey, Brian Floyd, Seth Van Essendelft, Richard S Zeri, MD,FACS, Walter J Pories, MD, FACSEast Carolina University, Greenville, NC
INTRODUCTION: Even though physicians incur most healthcare
costs this financial information is not readily available. Accordinglywe sought to determine knowledge of costs among medical profes-sionals at various points in their career.
METHODS: We surveyed 47 individuals including 18 attending
physicians, 20 residents and 9 MS3 regarding the charges for 6blood tests, EKG, 3 imaging studies and 10 medications, includingintravenous drugs. Charges were defined as “self-pay” costs at our
990 bed academic center.
RESULTS: The entire cohort, regardless of level of education,underestimated the charges for tests and medications, p>0.05(Table). Among (1 attendings vs residents, (2 attendings vs stu-dents, and (3 residents vs students there was no difference in
cost estimates (p>0.70), although there was an awareness inthe relationship of these costs (R2>0.95). Similarly price esti-
mates, as compared to actual costs, did not differ by type ofspecialty (IM vs surgery) regardless of level, p>0.05.Comparing estimated costs between specialties at each individ-
ual level of training, we identified that surgery attendings’ esti-mation of price was much greater than that of IM attendings,$181.03 vs $98.78, p¼0.06, while IM residents and students
on IM rotation had significantly greater estimations of priceas compared to their surgery counterparts, $183.49 vs$119.11 (p¼0.002) and $160.11 vs $134.47 (p¼0.04), respec-tively. This lack of understanding was most evident in the es-
timations for CT scans ($100 to $2,800).
Groups Average estimated price, $ p Value R square
Entire population
147.84 � 256.68 0.36 0.81All attendings
144.04 � 218.45 0.36 0.81All residents
151.33 � 296.29 0.35 0.78All students
147.02 � 249.18 0.35 0.83Junior attendings
146.42 � 241.20 0.36 0.74Senior attendings
142.83 � 203.85 0.36 0.85Junior residents
153.03 � 306.47 0.35 0.75Senior residents
149.68 � 286.99 0.34 0.81CONCLUSIONS: Attending physicians and surgeons, residentsand students are equally ignorant of costs of tests, imaging andmedications. In an era of rising healthcare costs this deficit deservesserious review.