Teaching the Cost of Hospital Care to Medical Students

Abstract

Abstract Physicians significantly influence health care spending, yet little time is spent in medical education addressing the financial costs of health care. This resource is a 2-hour case-based instructional session that aims to impact students' knowledge and attitudes regarding the integration of costs into medical decision-making. A survey of medical students revealed that most believed that the cost associated with diagnostic testing was infrequently considered in medical decision-making. Moreover, students felt that only a minority of residents or attending physicians routinely discussed the cost of care as a component of patient management. This case describes a common clinical scenario (severe pneumonia) and provides several typical decision points where incorporation of financial costs and evidence-based medicine into the decision-making process may alter the choices made. Specifically, the patient has evidence of significant pneumonia at the time of admission. As the facilitator sequentially presented the case, students were asked to expand the differential diagnosis and determine which tests to order, justifying each test they chose. Their decisions were compared to the narrative of the real case, and the real cost of each test was revealed. Students then discussed the costs of the tests and whether they were worth it. Postmodule, students answered four sample questions testing knowledge of health economics, showing an improvement over the premodule test. While students did not change their opinion that diagnostic accuracy is more important than cost, more students reported both that a patient's ability to pay should be considered and that the cost of a test should be discussed with the patient.

Keywords

• Economics
• Resource Utilization
• Financial Management
• Clinical Clerkship
• Cost Management