Patient administrative burden: a scoping review

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.