A COMPUTER EDUCATION-PROGRAM TO IMPROVE PHYSICIAN AWARENESS OF REHABILITATION HOSPITAL CHARGES

Objective: To quantify physician knowledge of hospital charges and det ermine if computer fiscal feedback would improve physician awareness o f hospital charges. Design: Comparison of physicians' knowledge of hos pital charges before and 6 months after the instigation of a computer feedback educational program. Participants and Setting: All physicians (attendings, residents, and fellows) at a large academic rehabilitati on hospital. Intervention: After surveying physicians' knowledge of ho spital charges, the billing fees for some items were placed on the com puter ordering menu so that these charges were viewed when orders were made by physicians. Main Outcome Measures: Error in physician charge estimates before and after computer education program, and physician c onfidence in charge estimates. Results: The baseline survey found that physicians had poor awareness of hospital charges, regardless of orde ring frequency, relative charge for the item, or physician experience. Physicians expressed little confidence in their knowledge of the char ges and were twice as likely to underestimate than to overestimate cha rges. Six months after the implementation of a computer feedback educa tional program, improvement was seen in the awareness of hospital char ges for all imaging studies and most laboratory tests. Fiscal awarenes s of items that had not been included in the computer feedback also sh owed some small improvement. Physicians' confidence in their knowledge of fees improved. Physicians indicated the program was beneficial and should be expanded to include fiscal information on more services. Co nclusions: Immediate computer feedback of hospital charges improves ph ysicians' fiscal awareness and may lead to their practice of more cost -efficient medicine. (C) 1998 by the American Congress of Rehabilitati on Medicine and the American Academy of Physical Medicine and Rehabili tation.