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Discussing Health Care Expenses in the Oncology Clinic: Analysis of Cost Conversations in Outpatient Encounters.

Publication ,  Journal Article
Hunter, WG; Zafar, SY; Hesson, A; Davis, JK; Kirby, C; Barnett, JA; Ubel, PA
Published in: J Oncol Pract
November 2017

PURPOSE: ASCO identified oncologist-patient conversations about cancer costs as an important component of high-quality care. However, limited data exist characterizing the content of these conversations. We sought to provide novel insight into oncologist-patient cost conversations by determining the content of cost conversations in breast cancer clinic visits. METHODS: We performed content analysis of transcribed dialogue from 677 outpatient appointments for breast cancer management. Encounters featured 677 patients with breast cancer visiting 56 oncologists nationwide from 2010 to 2013. RESULTS: Cost conversations were identified in 22% of visits (95% CI, 19 to 25) and had a median duration of 33 seconds (interquartile range, 19 to 62). Fifty-nine percent of cost conversations were initiated by oncologists (95% CI, 51 to 67), who most commonly brought up costs for antineoplastic agents. By contrast, patients most frequently brought up costs for diagnostic tests. Thirty-eight percent of cost conversations mentioned cost-reducing strategies (95% CI, 30 to 46), which most commonly sought to lower patient costs for endocrine therapies and symptom-alleviating treatments. The three most commonly discussed cost-reducing strategies were: switching to a lower-cost therapy/diagnostic, changing logistics of the intervention, and facilitating copay assistance. CONCLUSION: We identified cost conversations in approximately one in five breast cancer visits. Cost conversations were mostly oncologist initiated, lasted < 1 minute, and dealt with a wide range of health care expenses. Cost-reducing strategies were mentioned in more than one third of cost conversations and often involved switching antineoplastic agents for lower-cost alternatives or altering logistics of diagnostic tests.

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Published In

J Oncol Pract

DOI

EISSN

1935-469X

Publication Date

November 2017

Volume

13

Issue

11

Start / End Page

e944 / e956

Location

United States

Related Subject Headings

  • Young Adult
  • Quality of Health Care
  • Physician-Patient Relations
  • Oncology & Carcinogenesis
  • Oncologists
  • Molecular Diagnostic Techniques
  • Middle Aged
  • Medical Oncology
  • Male
  • Humans
 

Citation

APA
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Hunter, W. G., Zafar, S. Y., Hesson, A., Davis, J. K., Kirby, C., Barnett, J. A., & Ubel, P. A. (2017). Discussing Health Care Expenses in the Oncology Clinic: Analysis of Cost Conversations in Outpatient Encounters. J Oncol Pract, 13(11), e944–e956. https://doi.org/10.1200/JOP.2017.022855
Hunter, Wynn G., S Yousuf Zafar, Ashley Hesson, J Kelly Davis, Christine Kirby, Jamison A. Barnett, and Peter A. Ubel. “Discussing Health Care Expenses in the Oncology Clinic: Analysis of Cost Conversations in Outpatient Encounters.J Oncol Pract 13, no. 11 (November 2017): e944–56. https://doi.org/10.1200/JOP.2017.022855.
Hunter WG, Zafar SY, Hesson A, Davis JK, Kirby C, Barnett JA, et al. Discussing Health Care Expenses in the Oncology Clinic: Analysis of Cost Conversations in Outpatient Encounters. J Oncol Pract. 2017 Nov;13(11):e944–56.
Hunter, Wynn G., et al. “Discussing Health Care Expenses in the Oncology Clinic: Analysis of Cost Conversations in Outpatient Encounters.J Oncol Pract, vol. 13, no. 11, Nov. 2017, pp. e944–56. Pubmed, doi:10.1200/JOP.2017.022855.
Hunter WG, Zafar SY, Hesson A, Davis JK, Kirby C, Barnett JA, Ubel PA. Discussing Health Care Expenses in the Oncology Clinic: Analysis of Cost Conversations in Outpatient Encounters. J Oncol Pract. 2017 Nov;13(11):e944–e956.

Published In

J Oncol Pract

DOI

EISSN

1935-469X

Publication Date

November 2017

Volume

13

Issue

11

Start / End Page

e944 / e956

Location

United States

Related Subject Headings

  • Young Adult
  • Quality of Health Care
  • Physician-Patient Relations
  • Oncology & Carcinogenesis
  • Oncologists
  • Molecular Diagnostic Techniques
  • Middle Aged
  • Medical Oncology
  • Male
  • Humans