Alokozai Aaron, Crijns Tom J, Janssen Stein J, Van Der Gronde Bonheur, Ring David, Sox-Harris Alex, Kamal Robin N
VOICES Health Policy Research Center, Department of Orthopaedic Surgery, Stanford University Hospitals, Redwood City, CA.
Department of Surgery and Perioperative Care, Dell Medical School, Austin, TX.
J Hand Surg Am. 2019 Nov;44(11):992.e1-992.e26. doi: 10.1016/j.jhsa.2019.01.009. Epub 2019 Feb 21.
Rising costs at the patient level have been recognized and shown to directly influence patient decisions. By understanding patient interests in discussing cost, hand surgeons may better prepare themselves and their practices to communicate costs with patients.
We surveyed 128 patients at an upper extremity surgery clinic at their 2-week postoperative visit. Survey domains included basic patient demographics and an assessment of patient financial distress, along with questions that rated patient interest with patient-physician financial conversations. These factors included patients' desire for a conversation regarding cost, whether or not patients have discussed cost with their surgeon, barriers to these discussions, and overall views concerning cost containment in hand care.
Seven percent of patients discussed the costs of their surgical care with their physician. Eleven percent of patients reported that a doctor should not discuss the costs of their surgical care. Forty-eight percent of patients reported that a doctor should initiate a conversation regarding costs of care when a new treatment is being considered. Fifty-nine percent of patients agreed that physicians should consider the amount of money a patient will have to pay when choosing a new treatment.
Patients can experience financial hardship as a result of their surgery and some patients are interested in discussing costs with their doctor. Patients indicated that doctors should be concerned with lowering the costs of surgery and should initiate a conversation regarding costs of care when a new treatment is being considered.
Patients are interested in a conversation regarding their cost of hand surgery care. Making cost data more transparent and available to physicians and patients may facilitate communication regarding cost of care.
患者层面不断上升的费用已得到认识，并显示出直接影响患者的决策。通过了解患者在讨论费用方面的兴趣，手外科医生可以更好地为自己和他们的医疗机构做好准备，以便与患者沟通费用问题。
我们在一家上肢外科诊所对128名患者进行了术后2周随访调查。调查领域包括患者基本人口统计学信息、患者财务困境评估，以及对患者与医生进行财务对话兴趣的评分问题。这些因素包括患者对费用对话的渴望、患者是否与外科医生讨论过费用、这些讨论的障碍，以及对手部护理费用控制的总体看法。
7%的患者与医生讨论了手术护理费用。11%的患者表示医生不应讨论他们的手术护理费用。48%的患者表示，当考虑新的治疗方法时，医生应该开始讨论护理费用。59%的患者同意医生在选择新治疗方法时应考虑患者需要支付的费用金额。
患者可能因手术而面临经济困难，一些患者有兴趣与医生讨论费用问题。患者表示医生应该关注降低手术费用，并在考虑新的治疗方法时开始讨论护理费用。
患者有兴趣就手部手术护理费用进行对话。使费用数据对医生和患者更加透明和可得，可能有助于促进关于护理费用的沟通。
