Abstract No. 482 - Understanding cost in interventional radiology and vascular surgery

Abstract

This study seeks to evaluate vascular interventional radiologists’ (VIRs’) and vascular surgeons’ (VSs’) knowledge on the costs of common devices and procedures, and to determine factors associated with differences in understanding. After IRB approval was obtained, an online survey was administered to US attending VIRs and VSs. Demographic information (e.g. length of time in practice, type of practice, location of practice, and participation in prior cost education training) and physicians’ opinions on hospital costs were elicited. Respondents were then asked to estimate the average prices of 15 commonly used surgical devices to the nearest dollar and to estimate the work Relative Value Units (wRVUs) and average Medicare reimbursement prices for 10 procedures. Price estimates were deemed correct if values were within ± 25% of the actual costs. Comparisons of individual questions were made using χ2 tests and logistic regression was used to model overall accuracy for group and type, with p values of <0.05 considered significant. Of the total 4,926 physicians contacted, 694/3,074 (22.6%) of VIRs and 396/1,852 (21.4%) of VSs returned the questionnaire. Overall, among VIRs and VSs, 19.5% (95% CI, 18.8-20.3%), 30.9% (95% CI, 29.0-32.9%), and 20.3% (95% CI, 18.6-22.2%) were accurate in the price estimations of devices, procedures in wRVU, and procedures in Medicare reimbursement, respectively. Both groups of physicians were statistically better at estimating the prices of procedures in wRVU than in Medicare reimbursement dollars (p <0.0001). Physicians who felt adequately educated about wRVUs were more accurate in predicting procedural costs in wRVU than those who responded otherwise (p <0.003). VIRs and VSs who indicated that cost never played a role in their daily equipment choice were less accurate in device cost estimations (p <0.05). This study suggests that VIRs and VSs alike have a deficiency of knowledge regarding procedural costs. Therefore, 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.