Hoffman KA, Mancini M. Emergency Health Care Professionals’ Understanding of the Costs of Care in the Emergency Department. J Am Osteopath Assoc 2017;117(6):359–364. doi: https://doi.org/10.7556/jaoa.2017.073.
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Efficiency and fiscal responsibility are important to the equal, safe, and effective delivery of care in the emergency department, where all presenting patients must be evaluated for emergent conditions. Health care professionals’ understanding of the costs of care is a first step to developing rational approaches for the efficient distribution of the finite resources hospitals and emergency departments have at their disposal to reduce costs to patients and health care systems.
To determine emergency department health care professionals’ knowledge of the costs to patients of routine care delivered in the emergency department.
An internet-based survey of currently practicing emergency medicine health care professionals with various levels of training (physicians, residents, physician assistants, and nurse practitioners) was conducted to evaluate their ability to identify the cost of care for 3 common presentations to the emergency department: abdominal pain, dyspnea, and sore throat.
Four hundred forty-one emergency medicine health care professionals participated. In the 3 cases presented, correct costs were determined by 43.0%, 32.0%, and 40.1% of participants, respectively. Geographic region was not related to cost determination. Larger institution size was related to greater cost chosen (P=.01). Higher level of training was significantly correlated with perceived understanding of cost (P<.001); however, it was not related to accurate cost assessment in this study.
Emergency medicine health care professionals have an inadequate understanding of the costs associated with care routinely provided in the emergency department.
a Charges were predetermined by the billing department at Lakeland Health in St. Joseph, Michigan.
Abbreviations: BiPAP, bilevel positive airway pressure; BNP, brain-type natriuretic peptide; CBC, complete blood cell count; CHF, congestive heart failure; CMP, complete metabolic panel; CT, computed tomography; ED, emergency department; EKG, electrocardiography; IV, intravenous; LVH, left ventricular hypertrophy; PCP, primary care physician; RLQ, right lower quadrant; RUQ, right upper quadrant.
Abbreviation: PGY, postgraduate year.
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