ArticleBMC health services research2016
Patient-physician discussions about costs: definitions and impact on cost conversation incidence estimates.
Article in BMC health services research, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 37 papers, 1 of them a synthesis that pooled it.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
37 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Communication of costs and financial burdens between cancer patients and healthcare providers: a qualitative systematic review and meta-synthesis.Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 2023Pooled it
- Cost Conversations About Anticoagulation Between Patients With Atrial Fibrillation and Their Clinicians: A Secondary Analysis of a Randomized Clinical Trial.JAMA network open · 2021Trial
- Patient Perspectives on Health Insurance Design: A Mixed-Methods Analysis.Journal of market access & health policy · 2025Article
- Article
- Understanding cancer survivor cost communication experiences and preferences.Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 2025Article
- Out-of-pocket prescription medicine expenditure amongst community-dwelling adults: Findings from the Irish longitudinal study on ageing (TILDA) in 2016.Exploratory research in clinical and social pharmacy · 2025Article
- How do people with multimorbidity prioritise healthcare when faced with tighter financial constraints? A national survey with a choice experiment component.BMC primary care · 2025Article
- Examining the Relationship Between the Quality of Cost Conversations and Patient Satisfaction in the Oral Health Setting.Journal of patient experience · 2025Article
- National survey of patient perspectives on cost discussions among recipients of copay assistance.The oncologist · 2024Article
- There's no place like home: optimizing the antepartum inpatient experience.Maternal health, neonatology and perinatology · 2024Article
- Financial toxicity and patient experience associated with financial burden of molecular-targeted and immune therapies for cancer: an observational study under public health insurance.International journal of clinical oncology · 2024Observational
- Optimization of Diagnosis-Related Groups for 14,246 Patients with Uterine Leiomyoma in a Single Center in Western China Using a Machine Learning Model.Risk management and healthcare policy · 2024Article
- The potential impact of introducing a cost tool to facilitate cost-of-care conversations in routine OB care: Lessons from the CONTINUE pilot study.PEC innovation · 2023Article
- Medication affordability discussions with older adults in primary care.Exploratory research in clinical and social pharmacy · 2023Article
- Physician Perspectives on Implementation of Real-Time Benefit Tools: A Qualitative Study.Applied clinical informatics · 2022Article
- Managing the economic challenges in the treatment of heart failure.BMC cardiovascular disorders · 2021Review
- Accuracy of Physician Estimates of Out-of-Pocket Costs for Medication Filling.JAMA network open · 2021Article
- Social Factors of Health Care: a Thematic Analysis of First and Second Year Medical Student Reflections.Medical science educator · 2021Article
- Impact of Cost Conversation on Decision-Making Outcomes.Mayo Clinic proceedings. Innovations, quality & outcomes · 2021Article
- Using Shared Decision-Making Tools and Patient-Clinician Conversations About Costs.Mayo Clinic proceedings. Innovations, quality & outcomes · 2020Article
Corrections and comments
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Authors and funding
7 authors.
Funding
Abstract
backgroundNearly one in three Americans are financially burdened by their medical expenses. To mitigate financial distress, experts recommend routine physician-patient cost conversations. However, the content and incidence of these conversations are unclear, and rigorous definitions are lacking. We sought to develop a novel set of cost conversation definitions, and determine the impact of definitional variation on cost conversation incidence in three clinical settings.
methodsRetrospective, mixed-methods analysis of transcribed dialogue from 1,755 outpatient encounters for routine clinical management of breast cancer, rheumatoid arthritis, and depression, occurring between 2010-2014. We developed cost conversation definitions using summative content analysis. Transcripts were evaluated independently by at least two members of our multi-disciplinary team to determine cost conversation incidence using each definition. Incidence estimates were compared using Pearson's Chi-Square Tests.
resultsThree cost conversation definitions emerged from our analysis: (a) Out-of-Pocket (OoP) Cost--discussion of the patient's OoP costs for a healthcare service; (b) Cost/Coverage--discussion of the patient's OoP costs or insurance coverage; (c) Cost of Illness- discussion of financial costs or insurance coverage related to health or healthcare. These definitions were hierarchical; OoP Cost was a subset of Cost/Coverage, which was a subset of Cost of Illness. In each clinical setting, we observed significant variation in the incidence of cost conversations when using different definitions; breast oncology: 16, 22, 24% of clinic visits contained cost conversation (OOP Cost, Cost/Coverage, Cost of Illness, respectively; P < 0.001); depression: 30, 38, 43%, (P < 0.001); and rheumatoid arthritis, 26, 33, 35%, (P < 0.001).
conclusionsThe estimated incidence of physician-patient cost conversation varied significantly depending on the definition used. Our findings and proposed definitions may assist in retrospective interpretation and prospective design of investigations on this topic.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.