Kuiken T, Prather H, Bloom S
Rehabilitation Institute of Chicago, IL, USA.
Am J Phys Med Rehabil. 1996 Nov-Dec;75(6):416-21. doi: 10.1097/00002060-199611000-00004.
Containment of health care costs is a pressing national issue. In this study, we examined physician knowledge of rehabilitation hospital costs by quantifying their awareness of hospital charges. All physicians at a free-standing rehabilitation hospital were surveyed. Approximately one-half of the physicians responded, including 19 attending and 17 resident physicians. The survey addressed three issues: physicians' estimate of the billing fee (hospital charge to the patient) for various items; how confident they were of the charge; and how frequently they ordered each item. The survey listed 65 items including diagnostic testing, drugs, therapies, and equipment. The average error in the charge estimates was quite large. For example, it was 52, 48, and 108% for hematologic tests, imaging studies, and pharmaceuticals, respectively. Charges were underestimated twice as often as they were overestimated. Physicians' confidence in their knowledge of these fees was quite low. They indicated that they were guessing 80 to 90% of the time, had an idea of the cost for 10 to 20% of the items, and were confident in their knowledge for less than 1% of the items. There were no significant correlations between accuracy of the charge estimates and ordering frequency, actual charge of the item, or experience level of the physicians.
控制医疗费用是一个紧迫的国家问题。在本研究中，我们通过量化医生对医院收费的认知，来考察他们对康复医院费用的了解情况。我们对一家独立康复医院的所有医生进行了调查。约一半的医生回复了调查，其中包括19名主治医生和17名住院医生。该调查涉及三个问题：医生对各类项目计费费用（医院向患者收取的费用）的估计；他们对收费的信心程度；以及他们开具每项检查的频率。调查列出了65个项目，包括诊断检测、药物、治疗和设备。收费估计的平均误差相当大。例如，血液学检查、影像学检查和药品的误差分别为52%、48%和108%。收费被低估的频率是被高估频率的两倍。医生对这些费用的了解信心很低。他们表示，80%至90%的情况下他们是在猜测，对10%至20%的项目有费用概念，而对不到1%的项目有信心。收费估计的准确性与开具频率、项目实际收费或医生经验水平之间没有显著相关性。
