Hospitalists are not very aware of the charges for various services they provide, or tests they order, according to data published in the May/June Journal of Hospital Medicine . If hospitalists are to succeed in improving cost efficiency, greater efforts may be needed to educate them about inpatient charges, the study authors wrote.
- Only 10.8% of hospitalists' cost estimates were within 10% of the actual unadjusted charge; 17.8% were within 20% of the charges; and 24.8% were within 30%.
- Hospitalists' estimates of the charges of relatively expensive items, like abdominal CT scans, overlapped with their estimates of the least expensive items, like urine cultures.
- The range of estimates different hospitalists made about the same care items in the same facilities was very broad.
- Dollar values aside, hospitalists tended to rank the expense of various items in roughly the correct order.
- “Admission services” was the care service with the highest percentage of charge estimates within 30% accuracy, at 52%.
- CT scan of the abdomen was the care service with the lowest percentage of charge estimates within 30% of accuracy, at 4%.
- The range of charge estimates for a complete metabolic panel was $15 to $1,200. The actual unadjusted charge was $37.
- The range of charge estimates for a 125-mg dose of IV methylprednisolone was $3 to $200. The actual unadjusted charge was $26.63.
- The mean estimate that came the closest to the actual unadjusted charge was for a 500-mg oral dose of levofloxacin. The mean estimate was $25 and the actual unadjusted charge was $29.78. The second-closest estimate was for urinalysis with microscopy. The mean estimate was $53, while the unadjusted charge was $37.