The acceptance of price lists at the emergency department: how do doctors think about it?

Background

In a recent study, it was shown that cost-awareness among physicians working at the Swedish emergency department is very low. In another study, it could be shown that price lists can reduce the costs of laboratory and radiological investigations ordered.

However, cost-cutting projects can result in irritation among physicians feeling themselves to be forced to implement cost-cutting in their daily work and might be considered to be both annoying and unnecessary. To get understanding of physicians view towards price-lists in their daily work we performed a study among physicians involved in patients at the emergency department of a university hospital.

Methods

An anonymized questionnaire was distributed among the internal medicine physicians of our university hospital. The data asked for were the level of qualification of the physician (consultant, specialist, senior house officer/registrar (SHO), junior house officer (JHO)), if the physician regarded price lists as a usable tool in their daily work (positive/negative) and if they assumed that knowledge about the costs for investigations would have an impact on the total expenses for investigations performed. The questionnaires were recollected by the hospitals internal mail. Statistical analysis was performed using the unpaired Student's T-test, accepting p-levels < 0.05 as significant.

Results

A total of 27 questionnaires were recollected by our method. Four consultants, 3 specialists, 16 SHOs and 4 JHOs chose to participate in the study.

4 of 4 consultants (100%), 2 of 3 specialists (66.67%), 12 of 16 SHO (75%) and 4 of 4 JHO (100%) considered price-lists to have an impact on the costs for clinical investigations (p < 0.01). 3 of 4 consultants (75%), 2 of 3 specialists (66.67%), 11 of 16 SHO (68.75%) and 4 of 4 JHO (100%) regarded price lists as a useful tool in their daily work (p = 0.051).

Conclusion

Medical doctors at our hospital involved in emergency patients regard price-lists as a possibly useful tool in their daily work, and do consider readily available price-lists to have a major impact on cost-cutting. Interestingly, no difference could be seen between the most junior and the most senior doctors participating in this study regarding their positive attitude towards such lists.