Attitudes of health care providers toward discussing treatment-associated costs with patients in the clinical settings: A cross-sectional study

Authors

1 Faculty of Nursing, Zarqa University, Zarqa, Jordan

2 Faculty of Economics and Administrative Science, Zarqa University, Zarqa, Jordan

3 Faculty of Nursing, Philadelphia University, Amman, Jordan

Abstract

Background: Some health care providers feel uncomfortable to lead cost communication. They spend most of their time providing psychological and physiological care, while the willingness to discuss costs with their patients is uncertain. Objective: We aimed to explore Jordanian nurses' and physicians' attitudes toward cost communication with patient and explore potential predictors of this action. Methods: Descriptive correlational survey design was conducted in 2019. A questionnaire was used to measure attitudes regarding the cost communication. A total of 122 Jordanian nurses and physician from a governmental hospital were participated in this study. Pearson's r coefficient correlation and multiple regression were used to analyze the data. Results: Jordanian health care providers demonstrated a positive attitude toward communicating cost issues with their patients. Most of them (68%), preferred to explain the cost that patients have to pay. The years of experience significantly predicted health care provider's positive attitude in cost discussion (β = 0.214, P < 0.05). Conclusion: Findings support the importance of discussing treatment-associated costs with patients. Jordanian healthcare providers are comfortable with and desire to discuss treatment-associated costs. Furthermore, the present findings emphasize to develop educational programs for health care provides to improve their financial and communication management skills.

Keywords


1.     Mukherjee T, Rahahleh NA, Lane W. The capital budgeting
process of healthcare organizations: A review of surveys.
J Healthc Manag 2016;61:58-76.
2.     Chapel JM, Wang G. Understanding cost data collection tools
to improve economic evaluations of health interventions. Stroke
Vasc Neurol 2019;4:214-22.
3.     Walton A, Lake D, Mullinix C, Allen D, Mooney K. Enabling
nurses to lead change: The orientation experiences of nurses to
boards. Nurs Outlook 2015;63:110-6.
4.     Bloudek LM, Stokes M, Buse DC, Wilcox TK, Lipton RB,
Goadsby PJ, et al. Cost of healthcare for patients with migraine
in five European countries: Results from the International Burden
of Migraine Study (IBMS). J Headache Pain 2012;13:361-78.
5.     Scott AM, Harrington NG, Spencer E. Primary care physicians’
strategic pursuit of multiple goals in cost-of-care conversations
with patients. Health Commun 2021;36:927-39.
6.     Salman M, Mustafa ZU, Asif N, Zaidi HA, Hussain K,
Shehzadi N, et al. Knowledge, attitude and preventive
practices related to COVID-19: A cross-sectional study in
two Pakistani university populations. Drugs Ther Perspect
2020;36:319-325.
7.     Ministry of Health, J. The Highlights of 2017; 2017.
p. 1-48. Available from: https://www.moh.gov.jo/.
[Last accessed on 2017 Oct 20].
8.     Hammad EA, Fardous T, Abbadi I. Costs of hospital services in
Jordan. Int J Health Plann Manage 2017;32:388-99.
9.     Alabbadi I. Cost impact of purchasing pharmaceuticals jointly
in the public health sector in Jordan. Jordan J Pharmaceut Sci
2011;4:97-104.
10.     Hamel LM, Penner LA, Eggly S, Chapman R, Klamerus JF,
Simon MS, et al. Do patients and oncologists discuss the cost of
cancer treatment? An observational study of clinical interactions
between African American patients and their oncologists. J Oncol
Pract 2017;13:e249-58.
11.     Ding JM, Zhang XZ, Hu XJ, Chen HL, Yu M. Analysis of
hospitalization expenditures and influencing factors for inpatients
with coronary heart disease in a tier-3 hospital in Xi’an, China:
A retrospective study. Medicine (Baltimore) 2017;96:e9341.
12.     Fralicx R. Strange bed (side) fellows physician-finance
collaboration. Healthc Financ Manage 2012;66:90-4, 96.
13.     Woo BF, Lee JX, Tam WW. The impact of the advanced practice
nursing role on quality of care, clinical outcomes, patient
satisfaction, and cost in the emergency and critical care settings:
A systematic review. Hum Resour Health 2017;15:63.
14.     Noh W, Lim JY. Nurses’ educational needs assessment for
financial management education using the nominal group
technique. Asian Nurs Res (Korean Soc Nurs Sci) 2015;9:152-7.
15.     Connor E. Healthcare finance and financial management:
Essentials for advanced practice nurses and interdisciplinary care
teams. J Med Libr Assoc 2015;103:111.
16.     Irwin B, Kimmick G, Altomare I, Marcom PK, Houck K,
Zafar SY, et al. Patient experience and attitudes toward addressing
the cost of breast cancer care. Oncologist 2014;19:1135-40.
17.     Gee J, Button M, Brooks G. The financial cost of healthcare
fraud: What data from around the world shows. MacIntyre
Hudson; 2010.
18.     McGuire TG. Physician agency and payment for primary medical
care. In: Glied S, Smith PC, editors. The Oxford Handbook of
Health Economics. Oxford, UK: Oxford university press; 2011.
19.     Shih YT, Chien CR. A review of cost communication in
oncology: Patient attitude, provider acceptance, and outcome
assessment. Cancer 2017;123:928-39.
20.     Hunter WG, Zhang CZ, Hesson A, Davis JK, Kirby C,
Williamson LD, et al. What strategies do physicians and patients
discuss to reduce out-of-pocket costs? Analysis of cost-saving
strategies in 1,755 outpatient clinic visits. Med Decis Making
2016;36:900-10.
21.     Brick DJ, Scherr KA, Ubel PA. The impact of cost conversations
on the patient-physician relationship. Health Commun
2019;34:65-73.
22.     Bullock AJ, Hofstatter EW, Yushak ML, Buss MK.
Understanding patients’ attitudes toward communication about
the cost of cancer care. J Oncol Pract 2012;8:e50-8.
23.     Altomare I, Irwin B, Zafar SY, Houck K, Maloney B, Greenup R,
et al. Physician experience and attitudes toward addressing the
cost of cancer care. J Oncol Pract 2016;12:e281-8.
24.     Leep Hunderfund AN, Dyrbye LN, Starr SR, Mandrekar J,
Naessens JM, Tilburt JC, et al. Role modeling and regional
health care intensity: U.S. medical student attitudes toward
and experiences with cost-conscious care. Acad Med
2017;92:694-702.
25.     Fendrick AM. Changing the Health Care Cost Discussion from”
How Much” to” How Well”; 2016. p. 16. Available from: https://
houstonbch.org/images/downloads/Program_Presentations/hbch_
nov._4_vbid_fendrick.pdf. [Last retrieved on 2014 Mar 10].
26.     Meltzer D, Manning WG, Morrison J, Shah MN, Jin L, Guth T,
et al. Effects of physician experience on costs and outcomes
on an academic general medicine service: Results of a trial of
hospitalists. Ann Intern Med 2002;137:866-74.
27.     Hammond DA, Chiu T, Painter JT, Meena N. Nonpharmacist
health care providers’ knowledge of and opinions regarding
medication costs in critically Ill patients. Hosp Pharm
2018;53:188-93.
28.     Conner K, Wiltshire J, Garcia E, Langland-Orban B, Anderson E,
Carrion I. et al. A Qualitative Exploration of Racial and Ethnic
Differences in Cost of Care Conversations among Older Adults;
2020.
29.     Blumenthal D, Chernof B, Fulmer T, Lumpkin J, Selberg J.
Caring for high-need, high-cost patients – An urgent priority.
N Engl J Med 2016;375:909-11.
30.     Mehrotra A, Reid RO, Adams JL, Friedberg MW, McGlynn EA,Hussey PS. Physicians with the least experience have higher cost
profiles than do physicians with the most experience. Health
Aff (Millwood) 2012;31:2453-63.
31.     Huang SS, Johnson KM, Ray GT, Wroe P, Lieu TA, Moore MR,
et al. Healthcare utilization and cost of pneumococcal disease in
the United States. Vaccine 2011;29:3398-412.
32.     Lim JY, Kim JH, Kim GM, Yoo JH. Effect of cost perception
and cost attitude on cost management behavior among clinical
nurses. J Korea Contents Associat 2016;16:113-23.
33.     Obeidat R, Khrais HI. Information needs and disclosure
preferences among Jordanian women diagnosed with breast
cancer. J Cancer Educ 2015;30:94-9.
34.     Harrington NG, Scott AM, Spencer EA. Working toward
evidence-based guidelines for cost-of-care conversations between
patients and physicians: A systematic review of the literature.
Soc Sci Med 2020;258:113084.