患者与医生的沟通关于自付费用
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
概括
患者和医生讨论自付费用的愿望很高,但实际讨论很少发生. 医生对患者财务负担的沟通至关重要,但在临床实践中经常被忽视.
科学领域:
- 医疗保健服务研究 医疗服务研究
- 医学经济学 医学经济学
- 患者与医生的沟通 患者与医生的沟通
背景情况:
- 自助医疗费用占医疗保健开支的重要且不断增长的部分.
- 这些成本与不服药和患者的财务负担有关.
- 对于患者和医生之间关于这些财务方面的沟通,人们的理解有限.
研究的目的:
- 调查患者和医生的观点,讨论出口袋医疗保健费用.
- 确定这些成本讨论的频率和预测因素.
- 评估医生对患者与自付费用相关的财务负担的认识.
主要方法:
- 对133名全科医生和484名成年门诊患者进行了横截面对照调查.
- 在芝加哥大都市区的学术和社区普通医学实践中进行.
- 收集关于信念,讨论频率,预测因素和医生对患者成本负担的认识的数据.
主要成果:
- 大多数患者 (63%) 和医生 (79%) 认为讨论自付费用是很重要的.
- 讨论很少发生,只有35%的医生和15%的患者报告.
- 讨论更有可能发生在那些经历了财务负担的患者和社区实践中.
结论:
- 尽管大家都相信讨论自付费用的重要性,但这种谈话很少发生.
- 关于患者财务负担的医生沟通是一个潜在的重要但被忽视的临床实践.
- 需要进一步的研究来探索增强成本沟通的流行,原因和影响.
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