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.