Brown Tawanna, Apenteng Bettye A, Opoku Samuel T
J Am Dent Assoc. 2022 Sep;153(9):829-838. doi: 10.1016/j.adaj.2022.04.003. Epub 2022 May 16.
Patient-provider cost conversations can minimize cost-related barriers to health, while improving treatment adherence and patient satisfaction. The authors sought to identify factors associated with the occurrence of cost conversations in dentistry.
This was a cross-sectional study using data from an online, self-administered survey of US adults who had seen a dentist within the past 24 months at the time of the survey. Multivariable hierarchical logistic regression analysis was used to identify patient and provider characteristics associated with the occurrence of cost conversations.
Of the 370 respondents, approximately two-thirds (68%) reported having a cost conversation with their dental provider during their last dental visit. Cost conversations were more likely for patients aged 25 through 34 years (odds ratio [OR], 2.84; 95% CI, 1.54 to 5.24), 35 through 44 years (OR, 3.35; 95% CI, 1.50 to 7.51), and 55 through 64 years (OR, 3.39; 95% CI, 1.38 to 8.28) than patients aged 18 through 24 years. Cost conversations were less likely to occur during visits with dental hygienists than during visits with general or family dentists (OR, 0.25; 95% CI, 0.11 to 0.58). In addition, respondents from the South (OR, 1.90; 95% CI, 1.04 to 3.48) and those screened for financial hardship were more likely to report having cost conversations with their dental providers (OR, 6.70; 95% CI, 2.69 to 16.71).
Within the study sample, cost conversations were common and were facilitated via financial hardship screening.
Modifying oral health care delivery processes to incorporate financial hardship screening may be an effective way to facilitate cost conversations and provision of patient-centered care.
患者与医疗服务提供者之间关于费用的沟通可以减少与费用相关的健康障碍,同时提高治疗依从性和患者满意度。作者试图确定牙科领域中与费用沟通发生相关的因素。
这是一项横断面研究,使用的数据来自对美国成年人的在线自填式调查,这些成年人在调查时的过去24个月内看过牙医。多变量分层逻辑回归分析用于确定与费用沟通发生相关的患者和医疗服务提供者特征。
在370名受访者中,约三分之二(68%)报告在最近一次看牙时与牙科服务提供者进行了费用沟通。25至34岁的患者(优势比[OR],2.84;95%置信区间[CI],1.54至5.24)、35至44岁的患者(OR,3.35;95%CI,1.50至7.51)以及55至64岁的患者(OR,3.39;95%CI,1.38至8.28)比18至24岁的患者更有可能进行费用沟通。与普通或家庭牙医就诊相比,在与牙科保健员就诊期间进行费用沟通的可能性较小(OR,0.25;95%CI,0.11至0.58)。此外,来自南方的受访者(OR, 1.90;95%CI,1.04至3.48)以及那些接受过经济困难筛查的受访者更有可能报告与牙科服务提供者进行了费用沟通(OR,6.70;95%CI,2.69至16.71)。
在研究样本中,费用沟通很常见,并且通过经济困难筛查得以促进。
调整口腔医疗服务流程以纳入经济困难筛查可能是促进费用沟通和提供以患者为中心的护理的有效方法。