How aware are Belgian permanent and resident emergency physicians of common medical costs and radiation doses?

Abstract

Objectives: To establish how aware Belgian emergency physicians are of common treatment costs and radiation doses.

Materials and methods: Using a questionnaire survey on a voluntary basis, 60 emergency physicians from four universities and four district hospitals were asked to estimate treatment costs and radiation doses involved in the management of a patient with pulmonary embolism. The responses of permanent and resident physicians were then compared with actual data defined by the Belgian legislation. Physicians' error was calculated as a percentage of the real value using the formula [(real-estimated)/real]×100.

Results: Fifty questionnaires were fully completed and analysed. Estimated costs of diagnostic procedures (chest radiograph, ECG, pulmonary-computed tomography, Doppler legs, cardiac ultrasound, ventilation/perfusion scintigraphy), laboratory tests (standard, D-dimers, arterial blood gases), drugs (alteplase, enoxiparine, acenocoumarol) and hospitalization (emergency department, intensive care and pneumology units) were within 25% of real costs for 38, 14, 18 and 30%, respectively, of permanent physicians and 31, 12, 8 and 27% of resident physicians. Drug prices were generally largely overestimated.Mean error of the physicians' estimates of the radiation dose of imaging modalities (chest radiograph, computed tomography and scintigraphy) was 1805% for permanent physicians versus 4997% for resident physicians. There was no significant difference between the two groups for the different items studied.

Conclusion: Emergency doctors, whether permanent physicians or resident physicians, have a limited knowledge of both costs and radiation doses of investigations and treatments they prescribe every day.