Department of Orthopaedic Surgery, Case Western Reserve University-University Hospitals Case Medical Center, 11100 Euclid Avenue, Cleveland, OH 44106, USA.
Clin Orthop Relat Res. 2013 Jun;471(6):1744-9. doi: 10.1007/s11999-012-2757-x.
A poor understanding of cost among healthcare providers may contribute to high healthcare expenditures. Currently, it is unclear whether and how much surgeons know about the costs of implantable medical devices (IMDs).
QUESTIONS/PURPOSES: We (1) determined the level of comfort with orthopaedic IMD costs among orthopaedic residents and attending surgeons, (2) quantified how accurately surgeons understand the costs of orthopaedic IMDs, and (3) identified which constructs yield the most accurate cost estimations among residents and attending surgeons.
A questionnaire was presented to 60 residents and 37 attending orthopaedic surgeons from two large academic medical centers. Respondents estimated the cost of 13 commonly used orthopaedic devices. Fifty-one surgeons participated (36 residents, 15 attending surgeons), for an overall response rate of 53%. Cost estimates were compared against the actual material costs, and we recorded the percentage error for each estimate.
More than ½ of the respondents rated their knowledge of IMD cost as poor. The mean percentage error in estimation for all respondents was 69% (range, 29%-289%). Overall, 67% of responses were underestimations and 33% were overestimations. Residents demonstrated a mean percentage error of 73% (range, 29%-289%) while attending surgeons had a mean percentage error of 59% (range, 49%-79%). Residents and attending surgeons demonstrated differences in accuracy within groups and between groups based on the IMD being estimated.
We found the knowledge of orthopaedic IMD costs among the orthopaedic residents and attending surgeons surveyed was poor. Further investigation of how physicians conceptualize material costs will be important to healthcare cost control.
医疗服务提供者对成本的理解不足可能导致医疗支出过高。目前，尚不清楚外科医生是否以及在多大程度上了解植入式医疗器械 (IMD) 的成本。
问题/目的：我们 (1) 确定了骨科住院医师和主治外科医生对骨科 IMD 成本的舒适度水平，(2) 量化了外科医生对骨科 IMD 成本的理解程度，以及 (3) 确定了哪些结构可以为住院医师和主治外科医生提供最准确的成本估算。
向来自两个大型学术医疗中心的 60 名住院医师和 37 名主治骨科医生提供了一份问卷。受访者估计了 13 种常用骨科设备的成本。有 51 名外科医生参与（36 名住院医师，15 名主治外科医生），总体回复率为 53%。将成本估算与实际材料成本进行比较，并记录每个估算的百分比误差。
超过一半的受访者表示他们对 IMD 成本的了解很差。所有受访者的估计平均百分比误差为 69%（范围，29%-289%）。总体而言，67%的回答是低估，33%是高估。住院医师的平均百分比误差为 73%（范围，29%-289%），而主治外科医生的平均百分比误差为 59%（范围，49%-79%）。住院医师和主治外科医生在估计的 IMD 组内和组间表现出准确性上的差异。
我们发现接受调查的骨科住院医师和主治外科医生对骨科 IMD 成本的了解很差。进一步研究医生如何概念化材料成本对于控制医疗成本非常重要。
