FRIDAY, May 10, 2019 -- Physicians are aware of patients' difficulty with affording medical care and consider out-of-pocket costs in their decision making, according to an article published in a supplement to the May 7 issue of the Annals of Internal Medicine.
Susan L. Perez, Ph.D., M.P.H., from California State University in Sacramento, and colleagues interviewed 20 internal medicine physicians and surveyed 621 internal medicine physician members of the American College of Physicians to examine the factors that influence discussion and consideration of cost during patient encounters.
The researchers identified four themes from the interviews: Physicians are aware that patients are struggling with the costs of medical care; rely on clues from patients that hint at cost sensitivity; rely on experience to anticipate potentially high-cost treatments; and are aware of the financial trade-off that patients make to pay for care. Three-quarters of the survey respondents reported considering out-of-pocket costs when making clinical decisions. Thirty-one percent of respondents reported wanting to discuss out-of-pocket prescription drug costs but not doing so. Respondents reported desire to be as thorough as possible and insurance coverage as the most influential factors for ordering tests (71 and 68 percent, respectively).
"Further research is needed to understand how to incorporate cost conversations into clinical interactions and to explore the impact of these conversations on medical decision making and patient outcomes," the authors write.
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