Technology

Cost Matters Most in Patient Preference for ED Diagnostic Testing

by U.S. Medicine

October 28, 2018

ANN ARBOR, MI — Diagnostic testing is often used during emergency department (ED) visits. But, in the rush to diagnosis and treat patients, often not much attention is paid to patient preferences for such testing, according to a recent study.

The article in Academic Emergency Medicine hypothesized that willingness to undergo diagnostic testing is influenced by a balance among the potential benefit to patients, as well as risk, and personal cost.1

A study team led by University of Michigan researchers and including participation from the Salt Lake City, UT, VAMC conducted a cross sectional survey among ED patients for diagnostic testing in two hypothetical scenarios: chest pain (CP) and mild traumatic brain injury (mTBI).

For each scenario, specific risks, benefits, and costs of testing were detailed. Researchers sought to calculate the odds of a participant desiring diagnostic testing.

Results indicated that patients opted for diagnostic testing 68.2% of the time, including 69.7% of CP and 66.7% of all mTBI scenarios.

The study team found that, in the CP scenario, 81% of participants desired free testing vs. 59% when it was associated with a $100 copay (difference = 22%, 95% confidence interval [CI] = 16% to 28%).

Results were similar in the mTBI scenario: 73% of adult participants desired free testing vs. 56% when charged a $100 copayment (difference = 17%, 95% CI = 11% to 24%).

“Benefit and risk had mixed effects across the scenarios,” the researchers noted, adding that, in fully adjusted models, the association between cost and desire for testing persisted in the CP (odds ratio [OR] = 0.33, 95% CI = 0.23 to 0.47) and adult mTBI (OR = 0.47, 95% CI = 0.33 to 0.67) scenarios.

“In this ED-based study, patient preferences for diagnostic testing differed significantly across levels of risk, benefit, and cost of diagnostic testing,” study authors concluded. “Cost was the strongest and most consistent factor associated with decreased desire for testing.”

1. Porath JD, Meka AP, Morrow C, Iyengar R, Shtull-Leber E, Fagerlin A, Meurer WJ. Patient Preferences for Diagnostic Testing in the Emergency Department: A Cross-sectional Study. Acad Emerg Med. 2018 Jun;25(6):627-633. doi: 10.1111/acem.13404. PubMed PMID: 29505177; PubMed Central PMCID: PMC5995656.


Comments are closed here.


Related Articles

HIV Patients Had Lower PC Incidence in VA Study

NEW YORK—Non-AIDS defining cancers are increasingly important contributors to health outcomes for aging persons with HIV (PWH), according to a recent conference presentation which also pointed out that, although prostate cancer is prevalent in aging... View Article

VA Study Finds No Link Between ADT, Dementia

LA JOLLA, CA—Research has been conflicting on whether androgen deprivation therapy is related to dementia. A research letter in JAMA Oncology pointed out that two studies reported a strong statistically significant association between ADT and... View Article


U.S. Medicine Recommends


More From technology

Technology

Ongoing IT Problems at VA Could Hamper Shared EMR System With DoD

WASHINGTON—High turnover among leadership, gaps in accountability, and long-standing problems in cybersecurity represent significant challenges for VA in its ongoing efforts to improve its IT infrastructure, oversight officials told legislators last month. These challenges will... View Article

Technology

VA Announces Plans to Create 3D-Printed Artificial Lung

3D Printing Already Personalizes Care in Other Ways ANN ARBOR, MI—VA scientists in Michigan recently announced they are working to create a three-dimensional-printed artificial lung. The lab-created lung could transform treatment for some of the... View Article

Technology

VA, DoD Formally Agree to Create 'Seamless' EHR System

After years of pressure from Congress and advocacy groups, the DoD and VA have formally agreed to work together to implement “a single, seamlessly integrated electronic health record that will accurately and efficiently share health data.”

Technology

Decision Tool Helps Decide Who Should Get Lung Cancer Screening

A new online decision tool helps clinicians determine when to recommend lung cancer screening for their patients.

Technology

A 'Trigger' Can Make Sure Abnormal TSH Levels Are Followed Up

In busy outpatient clinics, following up on abnormal test results too often falls by the wayside, according to a new study.

Subscribe to U.S. Medicine Print Magazine

U.S. Medicine is mailed free each month to physicians, pharmacists, nurse practitioners, physician assistants and administrators working for Veterans Affairs, Department of Defense and U.S. Public Health Service.

Subscribe Now

Receive Our Email Newsletter

Stay informed about federal medical news, clinical updates and reports on government topics for the federal healthcare professional.

Sign Up