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Cost-Sharing Not Likely to Reduce Health Care Costs

Physicians don't always consider out-of-pocket costs when making treatment decisions

THURSDAY, April 12 (HealthDay News) -- Efforts to reduce health care spending by involving the patient in cost-sharing will probably have a limited effect because many physicians don't consider patient out-of-pocket costs when making clinical decisions, researchers report in the April 9 issue of the Archives of Internal Medicine.

Hoangmai H. Pham, M.D., from the Center for Studying Health System Change in Washington, D.C., and colleagues analyzed data from 6,628 respondents to the Community Tracking Study Physician Survey. The phone survey included physicians from 60 metropolitan areas. Primary care physicians were oversampled, and radiologists, anesthesiologists and other specialists were excluded.

The investigators found that 78 percent of physicians considered out-of-pocket costs when prescribing drugs, 51.2 percent did so when selecting care settings and 40.2 percent considered costs when choosing diagnostic tests. Primary care physicians were more likely to consider out-of-pocket costs for all three decisions while physicians in large practices or HMOs considered costs when prescribing generic drugs.

"More aggressive interventions such as accessible, detailed, and user-friendly information on costs of specific services might broadly change physicians' clinical decision making, but only if they result in a significant improvement in how often and how well patients and physicians communicate with one another about cost burdens," the authors write.

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