Charges for Medical Care at Different Hospitals

Redelmeier, Donald A.; Bell, Chaim M.; Detsky, Allan S.; Pansegrau, Gary

doi:10.1001/archinte.160.10.1417

Cited by 11 publications

(6 citation statements)

References 42 publications

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“…In a 1997 letter to the editor in the British Medical Journal , the authors reported on their small investigation of 62 chemist shops in Bath, U.K., in which they found that the price charged for a month's supply of donepezil (Aricept; Eisai Inc, Woodcliff Lake, NJ) ranged from £68 to £120, and in general they found lower prices quoted by chemists that were not part of a chain ( Jones, Mann, and Saunders 1997). More recently, Redelmeier et al (2000) surveyed 66 hospitals from every large city in the United States and Canada and documented variation in hospital charges to individuals paying out of pocket; the price to an uninsured patient for filling a prescription for fluoxetine varied fourfold among hospital pharmacies, ranging from $26 to $93.…”

Section: Discussionmentioning

confidence: 99%

Variation in Drug Prices at Pharmacies: Are Prices Higher in Poorer Areas?

Gellad

Choudhry

Friedberg

et al. 2009

Health Services Research

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Objective To determine whether retail prices for prescription drugs are higher in poorer areas. Data Sources The MyFloridarx.com website, which provides retail prescription prices at Florida pharmacies, and median ZIP code income from the 2000 Census. Study Design We compared mean pharmacy prices for each of the four study drugs across ZIP code income groups. Pharmacies were classified as either chain pharmacies or independent pharmacies. Data Collection Prices were downloaded in November 2006. Principal Findings Across the four study drugs, mean prices were highest in the poorest ZIP codes: 9 percent above the statewide average. Independent pharmacies in the poorest ZIP codes charged the highest mean prices. Conclusions Retail prescription prices appear to be higher in poorer ZIP codes of Florida.

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Section: Discussionmentioning

confidence: 99%

Variation in Drug Prices at Pharmacies: Are Prices Higher in Poorer Areas?

Gellad

Choudhry

Friedberg

et al. 2009

Health Services Research

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“…Previous work using a similar methodology measured variation in charges for elective hospital procedures and generic prescription drugs. An overall coefficient of variation of 0.53 was reported across hospitals in the United States and Canada for prices of selected therapeutic services and a coefficient of variation of 0.16 was reported across pharmacies in Canada for prices of selected generic medications [7], [8]. Our calculated coefficient of variation for Ontario cataract surgeons suggests that the variability in price for a specialty lens is similar to other therapeutic services, but much greater than the variability in generic drug prices.…”

Section: Discussionmentioning

confidence: 71%

Variation in Prices Charged to Patients for Specialty Intraocular Lenses Inserted during Universally Covered Cataract Surgery

2012

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BackgroundPatients often pay for specialty intraocular lenses (IOLs) for cataract surgery covered by universal insurance. This practice creates the potential for inequitable pricing where the medical service provider is also the retailer. We measured the variation in prices between cataract surgeons for the same IOL and associated testing.MethodsWe telephoned every cataract surgeon in Ontario, Canada, and asked their price for the most common type of specialty IOL as a prospective patient. We measured the total prices quoted and variation between providers.ResultsWe contacted 404 ophthalmologists. There were 256 that performed cataract surgery but 127 offered the most commonly employed specialty IOL and would provide a price to patients over the telephone. We obtained prices from all 127 ophthalmologists. Prices for the same lens and associated testing varied substantially between ophthalmologists from $358 to $2790 (median $615, interquartile range $528–$915). There was variation in all components of the total out-of-pocket price, including the price for the IOL itself, charges for uninsured eye measurements, and non-specific supplemental fees.ConclusionAlthough cataract surgery is covered by public health insurance, some ophthalmologists charge much more than others for the same specialty IOL and associated testing. Greater access to price information and better regulatory control could help ensure patients receive fair value for out-of-pocket health expenses.

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“…10,27 Charges, which vary considerably for the same hospital service, are occasionally made transparent to clinicians because patients receive billed charges and may make providers aware of them. 16,28 The actual cost of services and reimbursements, however, are rarely revealed. In fact, they may be kept as proprietary information that cannot be disclosed under civil and/or criminal penalty.…”

Section: Figurementioning

confidence: 99%

General Pediatric Attending Physicians’ and Residents’ Knowledge of Inpatient Hospital Finances

2013

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BACKGROUND AND OBJECTIVE: There is evidence suggesting that physicians have a limited foundation of knowledge on health care finances and limited awareness of hospital costs and charges. The objective was to analyze general pediatric attending physicians’ and residents’ knowledge of costs, charges, and reimbursements for care rendered in the inpatient setting. METHODS: An online survey was administered to all general pediatric attending physicians who work on the inpatient service and the entire pediatric residency program at The Children’s Hospital of Philadelphia (CHOP) in spring of 2011. Participants’ estimates of costs, charges, and reimbursements for several common tests, medications, and services were obtained and analyzed. RESULTS: A total of 38 attending physicians and 100 residents participated in the study (84% and 76% response rates, respectively). The majority of both attending physicians (71%) and residents (75%) characterized their understanding as “Minimally knowledgeable” or “Completely unaware”. Only 15% of attending physicians’ estimates and 11% of residents’ estimates were within ±25% of true values across all surveyed costs, charges, and reimbursements. Percent error did not vary by level of experience or self-reported knowledge for attending physicians and residents. CONCLUSIONS: Attending physicians and residents demonstrated limited knowledge of costs, charges, and reimbursements as shown by a low accuracy of estimates and a high percent error, compared with the actual values. To meet expectations for competency in systems-based practice and to be effective stewards of medical resources, it appears that pediatricians need further financial education.

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Charges for Medical Care at Different Hospitals

Abstract: Charges for the same hospital service vary substantially. Greater visibility might reduce some variation by bringing outliers into closer scrutiny. Patients seeking care and paying out-of-pocket could save financially by comparison shopping.

Cited by 11 publications

References 42 publications

Variation in Drug Prices at Pharmacies: Are Prices Higher in Poorer Areas?

Variation in Drug Prices at Pharmacies: Are Prices Higher in Poorer Areas?

Variation in Prices Charged to Patients for Specialty Intraocular Lenses Inserted during Universally Covered Cataract Surgery

General Pediatric Attending Physicians’ and Residents’ Knowledge of Inpatient Hospital Finances

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