Cost awareness among Swedish physicians working at the emergency department

In Sweden the public health system is subject of increasing budget problems. Medical training in Sweden does not yet focus on the cost aspects in patients diagnoses and treatment.

This study was carried out to survey the general knowledge among physicians working in the emergency department about the cost of the usual diagnostic tests used in ruling out pulmonary embolism.

Knowledge about costs among Swedish physicians was evaluated in the context of the emergency department of a university hospital. Thirty physicians answered an anonymous questionnaire about the costs for several items used in the diagnosis of pulmonary embolism. Answers within +/-25% of the real costs were regarded as correct. Evaluation took into consideration the physicians' specialty and experience as emergency physician, house officer or consultant in internal medicine. Statistical analysis was carried out using the Student's t-test, Kruskal-Wallis test and Mann-Whitney U test where applicable. Probability levels of less than 0.05 were accepted as significant.

Mean deviation to the real cost was 52% with a correct estimation of an average 28%. No significant difference could be detected in this study among emergency department physicians, house officers and consultants in internal medicine regarding the cost awareness towards the items considered.

Generally cost awareness was considered low among all participating doctors. The level of experience seemed not to be related to better knowledge about prices. Younger doctors generally tended to underestimate the costs of investigation. Further education will be necessary to raise the level of cost awareness among hospital doctors.