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Patient-physician discussions about costs: definitions and impact on cost conversation incidence estimates

Overview of attention for article published in BMC Health Services Research, March 2016
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About this Attention Score

  • In the top 25% of all research outputs scored by Altmetric
  • High Attention Score compared to outputs of the same age (85th percentile)
  • Good Attention Score compared to outputs of the same age and source (75th percentile)

Mentioned by

twitter
18 tweeters

Citations

dimensions_citation
38 Dimensions

Readers on

mendeley
74 Mendeley
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Title
Patient-physician discussions about costs: definitions and impact on cost conversation incidence estimates
Published in
BMC Health Services Research, March 2016
DOI 10.1186/s12913-016-1353-2
Pubmed ID
Authors

Wynn G. Hunter, Ashley Hesson, J. Kelly Davis, Christine Kirby, Lillie D. Williamson, Jamison A. Barnett, Peter A. Ubel

Abstract

Nearly 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. Retrospective, 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. Three 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). The 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.

Twitter Demographics

The data shown below were collected from the profiles of 18 tweeters who shared this research output. Click here to find out more about how the information was compiled.

Mendeley readers

The data shown below were compiled from readership statistics for 74 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
United Kingdom 1 1%
United States 1 1%
Unknown 72 97%

Demographic breakdown

Readers by professional status Count As %
Researcher 13 18%
Student > Ph. D. Student 8 11%
Student > Doctoral Student 7 9%
Student > Master 7 9%
Other 6 8%
Other 15 20%
Unknown 18 24%
Readers by discipline Count As %
Medicine and Dentistry 15 20%
Nursing and Health Professions 14 19%
Psychology 5 7%
Social Sciences 3 4%
Pharmacology, Toxicology and Pharmaceutical Science 3 4%
Other 10 14%
Unknown 24 32%

Attention Score in Context

This research output has an Altmetric Attention Score of 12. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 08 April 2016.
All research outputs
#1,443,204
of 14,034,248 outputs
Outputs from BMC Health Services Research
#640
of 4,745 outputs
Outputs of similar age
#36,959
of 263,862 outputs
Outputs of similar age from BMC Health Services Research
#2
of 8 outputs
Altmetric has tracked 14,034,248 research outputs across all sources so far. Compared to these this one has done well and is in the 89th percentile: it's in the top 25% of all research outputs ever tracked by Altmetric.
So far Altmetric has tracked 4,745 research outputs from this source. They typically receive a little more attention than average, with a mean Attention Score of 6.6. This one has done well, scoring higher than 86% of its peers.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 263,862 tracked outputs that were published within six weeks on either side of this one in any source. This one has done well, scoring higher than 85% of its contemporaries.
We're also able to compare this research output to 8 others from the same source and published within six weeks on either side of this one. This one has scored higher than 6 of them.