Parent Preferences for Transparency of Their Child's Hospitalization Costs.

Autor:	Bassett HK; Division of Hospital Medicine, Department of Pediatrics, Stanford University School of Medicine, Stanford, California., Beck J; Department of Pediatrics, Seattle Children's Hospital, Seattle, Washington., Coller RJ; Deparment of Pediatrics, University of Wisconsin School of Medicine and Public Health, Madison., Flaherty B; Division of Pediatric Critical Care, Department of Pediatrics, Primary Children's Hospital, University of Utah, Salt Lake City., Tiedt KA; Deparment of Pediatrics, University of Wisconsin School of Medicine and Public Health, Madison., Hummel K; Division of Pediatric Critical Care, Department of Pediatrics, Primary Children's Hospital, University of Utah, Salt Lake City.; currently affiliated with Division of Cardiology, Department of Pediatrics, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts., Tchou MJ; Division of Hospital Medicine, Department of Pediatrics, Cincinnati Children's Hospital Medical Center, University of Cincinnati, Cincinnati, Ohio.; currently affiliated with Section of Hospital Medicine, Department of Pediatrics, Children's Hospital Colorado, University of Colorado Denver, Aurora., Kapphahn K; Quantitative Sciences Unit, Stanford University, Palo Alto, California., Walker L; Section of Hospital Medicine, Department of Pediatrics, Texas Children's Hospital, Baylor College of Medicine, Houston., Schroeder AR; Division of Hospital Medicine, Department of Pediatrics, Stanford University School of Medicine, Stanford, California.; Division of Critical Care, Department of Pediatrics, Stanford University School of Medicine, Palo Alto, California.
Jazyk:	angličtina
Zdroj:	JAMA network open [JAMA Netw Open] 2021 Sep 01; Vol. 4 (9), pp. e2126083. Date of Electronic Publication: 2021 Sep 01.
DOI:	10.1001/jamanetworkopen.2021.26083
Abstrakt:	Importance: Health care in the US is often expensive for families; however, there is little transparency in the cost of medical services. The extent to which parents want cost transparency in their children's care is not well characterized. Objective: To explore the preferences and experiences of parents of hospitalized children regarding the discussion and consideration of health care costs in the inpatient care of their children. Design, Setting, and Participants: This cross-sectional multicenter survey study included 6 geographically diverse university-affiliated US children's hospitals from November 3, 2017, to November 8, 2018. Participants included a convenience sample of English- and Spanish-speaking parents of hospitalized children nearing hospital discharge. Data were analyzed from January 1, 2020, to June 25, 2021. Main Outcomes and Measures: Parents' preferences and experiences regarding transparency of their child's health care costs. Multivariable linear regression examined associations between clinical and sociodemographic variables with parents' preferences for knowing, discussing, and considering costs in the clinical setting. Factors included family financial difficulties, child's level of chronic disease, insurance payer, deductible, family poverty level, race, ethnicity, parental educational level, and study site. Results: Of 644 invited participants, 526 (82%) were enrolled (290 [55%] male), of whom 362 (69%) were White individuals, 400 (76%) were non-Hispanic/Latino individuals, and 274 (52%) had children with private insurance. Overall, 397 families (75%) wanted to discuss their child's medical costs, but only 36 (7%) reported having a cost conversation. If cost discussions were to occur, 294 families (56%) would prefer to speak to a financial counselor. Ninety-eight families (19%) worried discussing costs would hurt the quality of their child's care. Families with a medical financial burden unrelated to their hospitalized child had higher mean agreement that their child's physician should consider the family's costs in medical decision-making than families without a medical financial burden (effect size, 0.55 [95% CI, 0.18-0.92]). No variables were consistently associated with cost transparency preferences. Conclusions and Relevance: Most parents want to discuss their child's costs during an acute hospitalization. Discussions of health care costs may be an important, relatively unexplored component of family-centered care. However, these discussions rarely occur, indicating a tremendous opportunity to engage and support families in this issue.
Databáze:	MEDLINE
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