患者と医師の間で,自費費用に関するコミュニケーション
G Caleb Alexander1, Lawrence P Casalino, David O Meltzer
1Robert Wood Johnson Clinical Scholars Program, University of Chicago, Chicago, Ill 60637, USA. calexand@medicine.bsd.uchicago.edu
JAMA
|August 21, 2003
まとめ
患者と医師が自費費用について議論したいという欲求は高いが,実際の議論はめったにない. 患者の経済的負担に関する医師のコミュニケーションは極めて重要ですが,臨床実践ではしばしば見過ごされています.
科学分野:
- 医療サービス 研究 医療サービス
- 医学経済学 医学経済学
- 患者と医師のコミュニケーション
背景:
- 自費医療費は,医療費の重要かつ増大する部分を占めています.
- これらの費用は,薬物不服従と患者の経済的負担と関連しています.
- これらの財務的側面に関する患者と医師のコミュニケーションに関する理解は限られている.
研究 の 目的:
- 患者と医師の観点から,自費医療費の議論について調べる.
- これらのコスト議論の頻度と予測要因を決定する.
- 医療費の負担に関する患者の財政的負担に対する医師の認識を評価する.
主な方法:
- 133人の全般内科医と484人の成人外科医を対象とした横断的ペア調査.
- シカゴ大都市圏の学術およびコミュニティの一般医学診療所で実施されます.
- 信念,議論の頻度,予測要因,患者の費用負担の医師の認識に関するデータを収集した.
主要な成果:
- ほとんどの患者 (63%) と医師 (79%) は,自費費用について議論することが重要だと考えている.
- 議論は稀であり,医師の35%と患者の15%だけが報告した.
- 議論は,財政的な負担を経験している患者とコミュニティの実践においてより多く見られた.
結論:
- 自費費について話し合うことの大切さに共通の信念があるにもかかわらず,このような会話は稀です.
- 患者の経済的負担に関する医師のコミュニケーションは,潜在的に重要な,しかし見過ごされている臨床実践です.
- 費用コミュニケーションの強化による流行,原因,影響について,さらなる研究が必要である.
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