A Cross-Sectional Survey of Interventional Radiologists and Vascular Surgeons Regarding the Cost and Reimbursement of Common Devices and Procedures

Abstract

Purpose To evaluate knowledge of interventional radiologists (IRs) and vascular surgeons (VSs) on the cost of common devices and procedures and to determine factors associated with differences in understanding. Materials and Methods An online survey was administered to US faculty IRs and VSs. Demographic information and physicians’ opinions on hospital costs were elicited. Respondents were asked to estimate the average price of 15 commonly used devices and to estimate the work relative value units (wRVUs) and average Medicare reimbursements for 10 procedures. Answer estimates were deemed correct if values were ± 25% of the actual costs. Multivariate logistical regression was used to calculate odds ratios and 95% confidence intervals. Results Of the 4,926 participants contacted, 1,090 (22.1%) completed the questionnaire. Overall, 19.8%, 22.8%, and 31.9% were accurate in price estimations of devices, Medicare reimbursement, and wRVUs for procedures. Physicians who thought themselves adequately educated about wRVUs were more accurate in predicting procedural costs in wRVUs than physicians who responded otherwise (odds ratio = 1.40, 95% confidence interval, 1.29–1.52; P < .0001). Estimation accuracies for procedures showed a positive trend in more experienced physicians (≥ 16 y), private practice physicians, and physicians who practice in rural areas. Conclusions This study suggests that IRs and VSs have limited knowledge regarding device costs. Given the current health care environment, more attention should be placed on cost education and awareness so that physicians can provide the most cost-effective care.

CIRSE Clinical Practice Manual

“…This includes personnel costs but to the same extent costs for consumables, something many IRs are not aware of. So-called cost-education may raise awareness of this issue and ultimately lead to more cost-effective care [ 50 ]. Especially in larger units, the problem of interfaces plays a key role.…”

Cost of open and laparoscopic distal gastrectomy: surgeon perceptions versus the reality of hospital spending

“…Generally, the accuracy of physician estimates obtained in the current study was similar to findings from previous studies that found poor physician awareness of costs related to both pharmaceuticals and nonpharmaceutical diagnostic and therapeutic interventions. 6,7,11,27 Previous research has suggested that surgeons tend to overestimate less expensive, more common surgical equipment and to underestimate the cost of more expensive, less common equipment. 11,28,29 Similarly, we found that surgeons tended to overestimate the total cost of the less expensive open procedure and underestimated the cost of the more expensive laparoscopic procedure.…”

Arthroplasty implants and materials: Cost awareness and value perception

“…Previous studies demonstrate that surgeons have not been able to predict cost well, both overestimating and underestimating costs [11,12]. In contrast to predicting the cost of an item, the ability to differentiate a more expensive item of two choices may be a more clinically relevant measure of cost knowledge.…”

“…There are currently only a handful of studies that assess cost knowledge and decision making in surgery, many of which are limited to surgeons and residents and exclude other members of the surgical team [11][12][13]. In an effort to further elucidate the effect of cost awareness among members of the surgical team, the current study aimed to investigate the perceptions of those at an academic institution about the cost differences and perceived value of commonly used materials and implants that are regularly used for TJA in the operating rooms (ORs) where they work.…”