Perspectives On Health Care Cost-Consciousness among Medical Students and Physicians

Authors

  • Balaji Arumugam Indira Medical College & Hospitals, Tiruvallur, Chennai
  • Sivapriya Kandallu RS Panimalar Medical College Hospital & Research Institute, Poonamalle, Chennai
  • Jeevanandham S Tagore Medical College & Hospital, Chennai

DOI:

https://doi.org/10.55489/njcm.1342022433

Keywords:

Cost conscious care, focus group discussion, health care expenditure, mixed method design, Qualitative research

Abstract

Introduction: Health care costs consciousness refers to care that aims to assess the benefits, harms and costs of interventions by the physicians. Rising health care costs have created an urgent need to improve physicians’ knowledge on health care costs for providing cost conscious care.

Objectives: This study was done to assess and compare the knowledge and attitude towards health care cost consciousness of the undergraduate medical students and interns.

Methodology: A Mixed Method study was done using a standardized questionnaire among 388 medical students and a Qualitative approach using In-depth interviews with 15 practicing physicians and a Focus group discussion to understand their perceptions on cost-conscious care and their opinions on introducing Cost-conscious curriculum for the medical students. Data analysed using a framework analytical approach and NVivo12.

Results: 84% of the students agreed that all health personnel should be familiar with health care costs, 84.5% agreed that inclusion of the health care cost consciousness in medical curriculum is important for their carrier. The themes emerged identified the various perceptions, determinants on health care costs, cost-conscious decision making and their responsibility as a physician.

Conclusion: The physicians and interns strongly suggested including a structured learning on Cost-Conscious Care as a part of medical education to educate and train the future physicians.

References

Sager A, Socolar D. Health Costs Absorb One-Quarter of Economic Growth, 2000–2005. Boston University of Public Health; 2005. Available at https://www.bu.edu/sph/files/2015/05/Health-Costs-Absorb-One-quarter-of-GDP-growth-Release-ch%E2%80%A6.pdf

Dresnick SJ, Roth WI, Linn BS, Pratt TC, Blum A. The physician's role in the cost-containment problem. JAMA. 1979;241(15):1606–9. doi: 10.1001/jama.1979.032904100380213. Available at https://jamanetwork.com/journals/jama/article-abstract/364379

Fowkes FG. Doctors' knowledge of the costs of medical care. Med Educ. 1985;19(2):113–7. doi: 10.1111/j.1365-2923. 1985.tb01150. x. Available at https://pubmed.ncbi.nlm.nih.gov/3982310/

Reichert S, Simon T, Halm EA. Physicians' attitudes about prescribing and knowledge of the costs of common medications. Arch Intern Med. 2000;160(18):2799–803. doi: 10.1001/archinte.160.18.2799.Available at https://pubmed.ncbi.nlm.nih.gov/11025790/

Varkey P, Murad MH, Braun C, Grall KJ, Saoji V. A review of cost-effectiveness, cost-containment and economics curricula in graduate medical education. J Eval Clin Pract. 2010;16(6):1055–62. doi: 10.1111/j.1365-2753.2009.01249. x. Available at https://pubmed.ncbi.nlm.nih.gov/20630001/

Matthew F. Covington, MD et al, Teaching Cost-Conscious Medicine: Impact of a Simple Educational Intervention on Appropriate Abdominal Imaging at a Community-Based Teaching Hospital. Journal of Graduate Medical Education, June 2013. 284 – 288. DOI: http://dx.doi.org/10.4300/JGME-D-12-00117.1 Available at https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3693695/

Owens DK, Qaseem A, Chou R, Shekelle P; Clinical Guidelines Committee of the American College of Physicians. High-value, cost-conscious health care: concepts for clinicians to evaluate the benefits, harms, and costs of medical interventions. Ann Intern Med. 2011;154(3):174-180. Available at https://www.acpjournals.org/doi/10.7326/0003-4819-154-3-201102010-00007

Andrea N. Leep Hunderfund et al, Attitudes toward cost-conscious care among U.S. physicians and medical students: analysis of national cross-sectional survey data by age and stage of training. BMC Med Educ. 2018; 18: 275. Available at https://pubmed.ncbi.nlm.nih.gov/30466489/

Five paradoxes of Indian Healthcare https://economictimes.indiatimes.com/industry/healthcare/biotech/healthcare/five-paradoxes-of-indian-healthcare/articleshow/65159929.cms

Competency Based Undergraduate Curriculum For the Indian Medical Graduate. (2019). [ebook] Medical council of India. Available at: https://www.mciindia.org/CMS/wp-content/uploads/2019/01/UG-Curriculum-Vol-I.pdf [Accessed 28 Nov. 2019].

Leon-Carlyle M, McQuillan R, Baiu I, Sullivan A, Dukhovny D, Shah N. Assessing Student Attitudes Regarding Cost- Consciousness in Medical Education. MedEdPublish. https://doi.org/10.15694/mep.2019.000012.1 Available at https://mededpublish.org/articles/8-12/v1/pdf?article_uuid=e23841e6-bec3-403b-a59e-235cb2e33ab9

Kimberly M. Tartaglia, MD, Nicholas Kman, MD, andCynthia Ledford,MD. Medical Student Perceptions of Cost-Conscious Care in an Internal Medicine Clerkship: A Thematic Analysis. J Gen Intern Med 30(10):1491–6 DOI: 10.1007/s11606-015-3324-4. Available at https://pubmed.ncbi.nlm.nih.gov/25931005/

Moriates C, Soni K, Lai A, Ranji S. The value in the evidence: teaching residents to "choose wisely". JAMA Intern Med. 2013; 173(4):308–10. Available at https://pubmed.ncbi.nlm.nih.gov/23358796/

Cooke M. Cost consciousness in patient care — what is medical education’s responsibility? N Engl J Med. 2010 04/08; 2014/04;362(14):1253–5. Available at https://pubmed.ncbi.nlm.nih.gov/20357275/

Moriates C, Dohan D, Spetz J, Sawaya GF. Defining competencies for education in health care value: recommendations from the University of California, San Francisco Center for Healthcare Value Training Initiative. Acad Med. 2014 Oct 28. Available at https://pubmed.ncbi.nlm.nih.gov/25354077/

Moriates C, Soni K, Lai A, Ranji S. The value in the evidence: teaching residents to "choose wisely". JAMA Intern Med. 2013; 173(4):308–10. Available at https://pubmed.ncbi.nlm.nih.gov/23358796/

Levy AE, Shah NT, Moriates C, Arora VM. Fostering value in clinical practice among future physicians: time to consider COST. Acad Med. 2014; 89(11):1440. Available at https://pubmed.ncbi.nlm.nih.gov/25350335/

Downloads

Published

2022-04-30

How to Cite

1.
Arumugam B, Kandallu RS S, Jeevanandham S. Perspectives On Health Care Cost-Consciousness among Medical Students and Physicians. Natl J Community Med [Internet]. 2022 Apr. 30 [cited 2024 Nov. 21];13(04):207-12. Available from: https://njcmindia.com/index.php/file/article/view/433

Issue

Section

Original Research Articles