Abstract
BackgroundSouth Africa has high healthcare expenses. Improving cost-consciousness could decrease government expenditure on healthcare.ObjectivesTo determine cost awareness of radiological studies among doctors at a tertiary hospital. The objective was met by assessing the accuracy of cost estimation according to the level of training and speciality, whether participants had received prior education/training related to cost awareness and if they had a desire to learn more about the cost of radiological imaging.MethodA cross-sectional survey was conducted in six clinical departments at Universitas Academic Hospital using an anonymous questionnaire that determined doctors’ cost awareness of five radiological studies. Each radiological study was answered using six different cost ranges, with one correct option. Costs were based on the Department of Health’s 2019 Uniform Patients Fee Schedule (UPFS).ResultsIn total, 131 (67.2%) of 195 questionnaires distributed to registrars and consultants were returned. Overall, low accuracy of cost estimation was observed, with 45.2% of the participants choosing only incorrect options. No participant estimated all five costs correctly. Only the Internal Medicine clinicians demonstrated a significant difference between registrars and consultants for the number of correct answers (median 0 and 1, respectively) (p = 0.04). No significant differences were found between specialities stratified by registrars/consultants. Most participants (88.6%) would like to learn about imaging costs. Only 2.3% of the participants had received prior education/training related to cost awareness of radiological studies.ConclusionDoctors were consistently inaccurate in estimating the cost of radiological studies. Educating doctors about the cost of radiological imaging could have a positive effect on healthcare expenditure.
Highlights
It is estimated that patient-care decisions made by doctors are responsible for more than 80% of the healthcare expenditure.[1]
The results of this study were similar to international studies conducted on cost awareness of radiological studies and a Johannesburg-based South African study done on the cost awareness of medical consumables among healthcare professionals.[2,11,12,13]
As doctors are largely responsible for healthcare expenditure, the results of this research suggest that educating doctors about the cost of radiological imaging can positively affect healthcare expenditure
Summary
It is estimated that patient-care decisions made by doctors are responsible for more than 80% of the healthcare expenditure.[1]. With the current economic situation, the South African government will benefit from mitigating fruitless and wasteful expenditure on healthcare costs. For this to be realised, it has to start with incorporating cost-consciousness into medical practice.[2]. When doctors are aware of the costs of radiological studies, it may reduce the number of studies requested, which would translate into reduced healthcare costs.[3,4] Decreasing unnecessary costs would mean that funds could be saved and reallocated to other critical healthcare burdens in South Africa such as tuberculosis, HIV and AIDS.[5] Inappropriate use of radiological studies adds to healthcare costs without improving the quality of care provided to patients.
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