Barriers to patient-physician communication about out-of-pocket costs

Alexander, G. Caleb; Casalino, Lawrence P.; Tseng, Chien Wen; McFadden, Diane; Meltzer, David O.

doi:10.1111/j.1525-1497.2004.30249.x

Cited by 160 publications

(171 citation statements)

References 13 publications

Supporting

Mentioning

165

Contrasting

Unclassified

Order By: Relevance

“…24 Attitudinal information about discussion of costs with physicians, physicians' consideration of costs when making recommendations, and physicians' proper role in controlling out-of-pocket costs was collected using published items or slightly modified versions of published items, and used a 5-point Likert scale. 25 …”

Section: Questionnairementioning

confidence: 99%

Exploring Public Attitudes Towards Approaches to Discussing Costs in the Clinical Encounter

et al. 2013

View full text Add to dashboard Cite

BACKGROUND:Patients' willingness to discuss costs of treatment alternatives with their physicians is uncertain. OBJECTIVE: To explore public attitudes toward doctorpatient discussions of insurer and out-of-pocket costs and to examine whether several possible communication strategies might enhance patient receptivity to discussing costs with their physicians. DESIGN: Focus group discussions and pre-discussion and post-discussion questionnaires. PARTICIPANTS: Two hundred and eleven insured individuals with mean age of 48 years, 51 % female, 34 % African American, 27 % Latino, and 50 % with incomes below 300 % of the federal poverty threshold, participated in 22 focus groups in Santa Monica, CA and in the Washington, DC metro area. MAIN MEASUREMENTS: Attitudes toward discussing out-of-pocket and insurer costs with physicians, and towards physicians' role in controlling costs; receptivity toward recommended communication strategies regarding costs. KEY RESULTS: Participants expressed more willingness to talk to doctors about personal costs than insurer costs. Older participants and sicker participants were more willing to talk to the doctor about all costs than younger and healthier participants (OR=1.8, p=0.004; OR=1.6, p =0.027 respectively). Participants who face cost-related barriers to accessing health care were in greater agreement than others that doctors should play a role in reducing out-of-pocket costs (OR=2.4, p=0.011). Participants did not endorse recommended communication strategies for discussing costs in the clinical encounter. In contrast, participants stated that trust in one's physician would enhance their willingness to discuss costs. Perceived impediments to discussing costs included rushed, impersonal visits, and clinicians who are insufficiently informed about costs. CONCLUSIONS: This study suggests that trusting relationships may be more conducive than any particular discussion strategy to facilitating doctor-patient

show abstract

Section: Questionnairementioning

confidence: 99%

Exploring Public Attitudes Towards Approaches to Discussing Costs in the Clinical Encounter

et al. 2013

View full text Add to dashboard Cite

show abstract

“…In addition, the issue of cost-related nonadherence is not routinely addressed during patient encounters. 4,[7][8][9][10][11][12][13][14][15] This study demonstrated that a single lecture given by pharmacy students to other health care professional students and current prescribers can improve knowledge of prescription drug cost-containment strategies targeting vulnerable patient populations and can increase the likelihood of collaboration between prescribers and pharmacists. While future studies should determine if this intervention changes clinical practice and reduces patients' actual OOP prescription drug costs, these results show that this lecture format is an efficient way to disseminate important and timely information to health care professionals as they begin to practice in the new health care delivery models outlined in health care reform.…”

Section: ■■ Conclusionmentioning

confidence: 75%

“…6 Even if the provider is aware of the prescription costs, the skill of helping patients manage OOP prescription drug costs is not consistently taught in health professional educational programs and is not routinely addressed during patient encounters. 4,[7][8][9][10][11][12][13][14][15] While a more informed, cost-conscious health care workforce is one step toward improvement in patient adherence with prescription drug therapy, recent health policy legislation is changing the way the health care workforce engages patients. Medical institutions have attempted to keep pace so that future health care providers are prepared and can effectively adapt to the evolving changes in health policy.…”

Section: Setting Intervention and Participantsmentioning

confidence: 99%

Pharmacy Students Teaching Prescribers Strategies to Lower Prescription Drug Costs for Underserved Patients

Stebbins¹,

Frear²,

Cutler³

et al. 2013

JMCP

View full text Add to dashboard Cite

BACKGROUND: The rising costs of health care and, in particular, prescription drugs remains a challenge. Health professionals' ability to promote cost-effective prescription drug use is critical, yet this subject is not included consistently in the curriculum of most health professional schools. As experts in prescription drug selection, use, and cost, pharmacists are in a unique position to help manage prescription drug regimens for the best therapeutic outcome, while also helping to keep patients' out-of-pocket (OOP) prescription drug costs low. In addition to promoting interprofessional collaboration, pharmacy student-led lectures may provide an effective means to teach prescription drug cost-savings strategies to other health professional students and current prescribers.

show abstract

“…Communication skills have not always been a strength of medical providers, 31 and pose even greater challenges in the controversial area of cost. 32 However, some programs have been shown to improve patientcentered communication during medical training and later during professional practice. 33 These and other educational interventions could be adapted to promote better conversations between physicians and patients about wise resource use.…”

Section: Discussionmentioning

confidence: 99%

Controlling Health Costs: Physician Responses to Patient Expectations for Medical Care

et al. 2014

View full text Add to dashboard Cite

Barriers to patient-physician communication about out-of-pocket costs

Abstract: BACKGROUND: Though many patients and physicians believe that they should discuss out-of-pocket costs, research suggests that they infrequently do.

Cited by 160 publications

References 13 publications

Exploring Public Attitudes Towards Approaches to Discussing Costs in the Clinical Encounter

Exploring Public Attitudes Towards Approaches to Discussing Costs in the Clinical Encounter

Pharmacy Students Teaching Prescribers Strategies to Lower Prescription Drug Costs for Underserved Patients

Controlling Health Costs: Physician Responses to Patient Expectations for Medical Care

Contact Info

Product

Resources

About