Cost awareness in urology: A nationwide survey

Abstract

Introduction: In the current economic climate with continuous expenditure reviews and financial constraints, clinicians should remain conscious of making cost-effective choices on consumables and medications. In this survey, we evaluated the cost awareness amongst UK urologists. This is an observational study in which urology clinicians were asked to estimate the cost of 10 commonly used medications and consumables in urology by completing a questionnaire. Methodology: The survey was primarily conducted at the BAUS Annual Meeting 2017 with subsequent responders at local hospitals and urological courses. The costs of consumables and medications were verified with the relevant companies and the 73rd edition of the British National Formulary. Result: There were 139 responders from across the UK (46 consultants, 64 training registrars, 13 trust grades doctors and 16 senior house officers (SHOs)). In total, 16 and 60% of all estimates were within ± 25% and ± 100% of the true cost of the items respectively. Approximately 97.1, 95.7 and 97.1% overestimated the cost of a 14Ch urethral catheter, Ciprofloxacin and Sildenafil, respectively; while 78.4 and 84.9% of responders underestimated the cost of a JJ ureteric stent and Solifenacin, respectively. On multivariate analysis, SHOs significantly overestimated the cost of urethral catheters, suprapubic catheterization kits and JJ ureteric stents compared to other clinician grades. Conclusion: Cost awareness among UK urologists is poor. Expensive items (e.g. JJ ureteric stent, Solifenacin) tend to be underestimated while inexpensive items (e.g. catheter, Ciprofloxacin, Sildenafil) tend to be overestimated. This lack of appreciation of value may have an impact on drug and consumable expenditure. Level of Evidence: Level 3

Investigation of the awareness of specialist physicians in Iran hospitals regarding treatment costs in 2022

“…The present study shows that experts' knowledge about service costs is poor, which is consistent with all the studies reviewed in this research, especially with Al Zamil's study. (4) In this study, the tendency to overestimate the costs of services was not evident, and for this reason, it is contrary to the studies of Ryan, Schmidt, Hernu, Phan, and Allan, which states that most of the participants tend to estimate the items as more expensive than the actual price (2,3,13,(15)(16)(17) .…”

“…to estimate According to the mentioned results, it can be concluded that the kidney and urinary tract specialists participating in this study had a tendency to take cheap items with their hands up and expensive items with their hands down. These results are consistent with the results of Phan, Sorber and Allan studies (10,11,13) .…”

Information Asymmetry in Hospitals: Evidence of the Lack of Cost Awareness in Clinicians

“…The survey asked about the ‘cost entailed’ and estimates of these were compared to actual costs. We employed the ratio of estimated costs to the actual costs and the proportion of estimates within 25% of the actual costs, which is in line with previous published papers and avoids issues with the variation in item costs [ 12 , 19 ]. Because of this variation in costs (a coronary angiogram is 1,000 times more costly than the least expensive item) the CIR and ratio estimates for the overall cost were skewed towards the most expensive item and these should be interpreted carefully.…”

“…One systematic review revealed that only 33% of doctors provided an estimate within 20% or 25% of the actual diagnostic costs [ 11 ]. This figure was only 16% for consumables and medications in a national survey of 139 UK urologists [ 12 ]. There is limited evidence on the factors contributing to the lack of cost awareness.…”