Discussion
Up to researchers’ knowledge, this is the first study conducted in
Jordan to describe nurses and physicians experiences toward cost
communication with their patients. We found that a majority of our
sample is felt comfortable to discuss cost issues with their patients;
also, Jordanian health care providers seem to prioritize treatment
benefit regardless of financial cost. In comparison with international
studies, this outcome is consistent with many of them. Different samples
of health care providers demonstrated moderate to high levels of
experiences in discussing cost issues with their patients20-22. However, this result is contradicting studies
conducted in US and found that most nurses and physicians are not
initiating discussions about cost issues, drug costs specifically, with
their patients 23,24.
A survey of medical physicians revealed that 90% agreed physicians have
a responsibility to contain costs in their discussions (Leep Hunderfund
et al., 2017). Our study indicates that physicians feel similarly,
because the majority of them, about 69%, agreed that it is their
responsibility to consider out-of-pocket costs to patients. However,
there is less agreement that it is the doctor’s role to explain the
costs society will have to pay for the patient’s treatment; only 31% of
our surveyed physicians agreed with that statement.
Although the majority of surveyed nurses and physicians feel comfortable
to initiate cost discussions, we found that many feel that there are
limited quality resources which assist them in cost discussions. Less
than half of the surveyed nurses and physicians (36% and 43%,
respectively) agreed that they had adequate resources to discuss costs,
which means that greater efforts toward educating healthcare providers’
about costs of care may be necessary.
Further, specific variables including age, years of experience, and
number of meeting patients/week were significantly correlated with the
experiences of discussing cost issues among the study sample. This
outcome was partially consistent with that of a previous study conducted
in USA, and found that physician’s year of experience associated with
their attitude toward discussing costs with patients, while, other
factors such as malpractice claims, disciplinary action, and the size of
the group in which the physician practices had no associations25. The years of experience was significantly
predicted and associated with health care providers’ discussion about
costs. It is expected that lack of experiences reflected into more
expensive care 26. That is, more experienced health
care providers may be more familiar about cost issues, thus, more
comfortable to talk about the finance issues 27.
The number of meeting patients/week was a correlated strongly with
health care providers’ discussion about costs, as 15.8% of the variance
in the data can be explained by this predictor. This result is
consistent with the finding of a previous literature that number of
exposure between patients and health care providers is associated with
discussions about costs 13,28,29.