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E-Patient Counseling Trial E-PACO: Computer Based Education versus Nurse Counseling for Patients to Prepare for Colonoscopy

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Patient administrative burden: a scoping review.

Michael Anne Kyle¹, Kimberly Y Feng², Carrie G Wade³

¹Department of Medical Ethics and Health Policy, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA 19104, United States.

Health Affairs Scholar

|November 24, 2025

Summary

Patient administrative burden, the nonclinical work patients do for healthcare, is significant. Understanding this burden is key to reducing overall healthcare costs and clinician burnout.

Keywords:

access to care administrative burden consumerism patient-centered care scoping review

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Area of Science:

Health Services Research
Healthcare Administration
Patient Experience

Background:

High administrative costs are a major issue in the US healthcare system, contributing to excess spending and clinician burnout.
Patient administrative burden, defined as the nonclinical administrative tasks patients undertake to navigate healthcare, is increasingly recognized as a critical factor.

Purpose of the Study:

To synthesize empirical evidence characterizing patient administrative burden in US healthcare delivery from 2002-2024.
To identify gaps in the research regarding patient administrative burden across the healthcare journey.

Main Methods:

A scoping review was conducted following the PRISMA-ScR framework, utilizing a systematic search across four indexed databases.
A conceptual model of patient administrative burden was developed to define inclusion and exclusion criteria for study selection.
Sixty-three studies were identified, spanning the patient journey from seeking care to resolving post-care issues.

Main Results:

Evidence was most robust for insurance selection during the care-seeking phase.
Patient roles in identifying and solving health system problems remain significantly understudied.
The identified studies covered various aspects of the patient journey, including seeking, receiving, and following up on care.

Conclusions:

Current measurements of healthcare administrative costs likely underestimate total expenses by excluding patient-facing administrative work.
Systematic data collection and incorporation of patient administrative burden measures are needed for a comprehensive accounting of healthcare costs.
Addressing patient administrative burden is essential for improving healthcare system efficiency and reducing overall costs.