PHYSICIAN AWARENESS OF REHABILITATION COSTS

Containment of health care costs is a pressing national issue. In this study, we examined physician knowledge of rehabilitation hospital cos ts by quantifying their awareness of hospital charges. All physicians at a free-standing rehabilitation hospital were surveyed. Approximatel y one-half of the physicians responded, including 19 attending and 17 resident physicians. The survey addressed three issues: physicians' es timate of the billing See (hospital charge to the patient) for various items; how confident they were of the charge; and how frequently they ordered each item. The survey listed 65 items including diagnostic te sting, drugs, therapies, and equipment. The average error in the charg e estimates was quite Targe, For example, it was 52, 48, and 108% for hematologic tests, imaging studies, and pharmaceuticals, respectively. Charges were underestimated twice as often as they were overestimated . Physicians' confidence in their knowledge of these fees was quite lo w. They indicated that they were guessing 80 to 90% of the time, had a n idea of the cost for 10 to 20% of the items, and were confident in t heir knowledge for less than 1% of the items. There were no significan t correlations between accuracy of the charge estimates and ordering f requency, actual charge of the item, or experience level of the physic ians.