Understanding the cost of dermatologic care: A survey study of dermatology providers, residents, and patients

• Published in: Journal of the American Academy of Dermatology 2017-04, Vol.76 (4), p.609-617
• Main Authors: Steen, Aaron J., MD, Mann, Julianne A., MD, Carlberg, Valerie M., MD, Kimball, Alexa B., MD, MPH, Musty, Michael J., MS, Simpson, Eric L., MD, MCR
• Format: Article
• Language: English
• Subjects: Adult; cost awareness; cost estimation; cost of care; Decision Making; Dermatologic Agents - economics; Dermatology; Dermatology - economics; Female; Health Care Costs; Health Care Surveys; high-value healthcare; Humans; Insurance Coverage; Insurance, Health, Reimbursement; Internship and Residency; Male; Middle Aged; Northwestern United States; Patient Compliance; Patients - psychology; Physician-Patient Relations; Physicians - psychology; Prescription Fees; Professional Practice; Skin Diseases - diagnosis; Skin Diseases - economics; Skin Diseases - therapy; Truth Disclosure
• ISSN: 0190-9622; 1097-6787
• DOI: 10.1016/j.jaad.2016.11.049

Background The American Academy of Dermatology recommends dermatologists understand the costs of dermatologic care. Objective This study sought to measure dermatology providers' understanding of the cost of dermatologic care and how those costs are communicated to patients. We also aimed to understand the perspectives of patients and dermatological trainees on how cost information enters into the care they receive or provide. Methods Surveys were systematically developed and distributed to 3 study populations: dermatology providers, residents, and patients. Results Response rates were over 95% in all 3 populations. Dermatology providers and residents consistently underestimated the costs of commonly recommended dermatologic medications but accurately predicted the cost of common dermatologic procedures. Dermatology patients preferred to know the cost of procedures and medications, even when covered by insurance. In this population, the costs of dermatologic medications frequently interfered with patients' ability to properly adhere to prescribed regimens. Limitations The surveyed population was limited to the northwestern United States and findings may not be generalizable. Cost estimations were based on average reimbursement rates, which vary by insurer. Conclusion Improving dermatology providers' awareness and communication of the costs of dermatologic care might enhance medical decision-making, improve adherence and outcomes, and potentially reduce overall health care expenditures.