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Adoption of cost consciousness: Attitudes, practices, and knowledge among Israeli physicians

Published online by Cambridge University Press:  24 January 2008

Rachel Wilf-Miron ,
Liad Uziel ,
Alexander Aviram ,
Abraham Carmeli ,
Mordechai Shani  and
Joshua Shemer
Rachel Wilf-Miron
Affiliation:
Maccabi Healthcare Services and Tel-Aviv University
Liad Uziel
Affiliation:
The Hebrew University of Jerusalem
Alexander Aviram
Affiliation:
Tel-Aviv University and Sheba Medical Center
Abraham Carmeli
Affiliation:
Pilat Management Consulting
Mordechai Shani
Affiliation:
Tel-Aviv University and Sheba Medical Center
Joshua Shemer
Affiliation:
Tel-Aviv University and Sheba Medical Center
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Abstract

Objectives: In a resource-constrained reality, physicians are facing polar demands—those of healthcare managements to adopt cost-conscious behaviors and those of ethical standards that obligate physicians to consider only their patients' best interests. In our study, we aimed to determine the attitudes, practices, and knowledge of healthcare costs among Israeli physicians.

Methods: A questionnaire was developed and mailed to a representative sample of physicians in Israel. The overall response rate was 51 percent. The study reviewed self-reported levels of cost consciousness in practice, attitudes, obstacles related to cost containment, and knowledge of the costs of medical resources.

Results: Forty-two percent of the physicians reported high levels of cost consciousness in their daily practice; 70 percent reported greater current cost consciousness in comparison to 5 years ago; 76 percent of the responses legitimized institutional demands for cost containment. Although 83 percent of the physicians that responded expressed the belief that economic thinking was inherently the role of management, only 39 percent thought it was part of the physician's role. It was found that predominant predictors of agreement to cost consciousness concepts were employment by a community health plan, a managerial position, participation in health economics seminars, and male gender.

Conclusions: Cost consciousness among physicians is related to a broad array of parameters. Interventions must emphasize the benefits of evidence-based medicine as an anchor for both cost containment and quality care, as well as providing assistance to physicians in accepting economic decision-making as part of their professional role.

Keywords

Health careCost containmentCost consciousnessPhysicianAttitudesIsrael
Type
GENERAL ESSAYS
Information
International Journal of Technology Assessment in Health Care , Volume 24 , Issue 1 , January 2008 , pp. 45 - 51
Copyright
Copyright © Cambridge University Press 2008

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