Carlson Joshua, Dachs Robert J
Department of Family Medicine, Ellis Hospital, Schenectady, NY.
Fam Med. 2015 Jun;47(6):466-9.
The Accreditation Council for Graduate Medical Education (ACGME) has mandated that resident training programs incorporate instruction on the economic reality of health care. Studies over the past 15 years have demonstrated that resident physicians, as well as physicians in practice, are unaware of the charges associated with commonly ordered diagnostic tests. The last study to document family medicine residents' knowledge of the hospital charges associated with diagnostic studies was published over 10 years ago. With increasing emphasis on cost containment in the past decade, we attempted to determine if any change over time had occurred in family medicine residents' knowledge of the charges associated with commonly ordered diagnostic studies.
Sixteen common laboratory and radiology tests were surveyed and distributed to 30 resident physicians at a community-based, family medicine residency program. Estimates within 25% of the actual charges were considered correct. These results were then compared to prior similar research. Correlation between years of completed training and percentage of correct estimates was also assessed.
A total of 26 of 30 surveys (87%) were completed and compared to actual charges. Only 81 (19%) of 416 estimates were within 25% of actual charges. No improvement was noted with advanced years of training. Compared to previous work, this study does not show gains in cost awareness among family medicine residents.
Family medicine residents remain largely unaware of the hospital charges associated with diagnostic studies despite increasing emphasis on cost containment. These results will hopefully expose the persistent lack of awareness of the costs associated with ordered radiology and laboratory studies.
毕业后医学教育认证委员会（ACGME）已强制要求住院医师培训项目纳入有关医疗保健经济现实的教学内容。过去15年的研究表明，住院医师以及执业医生并不了解常用诊断检查的费用。上一次记录家庭医学住院医师对与诊断研究相关的医院费用了解情况的研究是在10多年前发表的。随着过去十年对成本控制的日益重视，我们试图确定家庭医学住院医师对常用诊断研究相关费用的了解是否随时间发生了任何变化。
对16项常见的实验室和放射学检查进行调查，并分发给一个社区家庭医学住院医师培训项目的30名住院医师。估计费用在实际费用的25%以内被视为正确。然后将这些结果与之前的类似研究进行比较。还评估了完成培训的年限与正确估计百分比之间的相关性。
30份调查问卷中共有26份（87%）完成并与实际费用进行了比较。在416项估计中，只有81项（19%）在实际费用的25%以内。随着培训年限的增加，未发现有改善。与之前的研究相比，本研究未显示家庭医学住院医师在成本意识方面有所提高。
尽管对成本控制越来越重视，但家庭医学住院医师在很大程度上仍然不了解与诊断研究相关的医院费用。这些结果有望揭示对所开具的放射学和实验室检查相关费用一直缺乏认识的问题。
