title: [Cost awareness at emergencies: multicentric survey among prescribers].
abstract: OBJECTIVE
  Regular increasing of health-care expense brought about the development of medical implication in prescription control and the will to give more responsibility to prescribers. Emergency departments account for a large part of hospital expenses. This study was carried out to evaluate cost awareness among French emergency physicians.
  
  
  METHODS
  A questionnaire was sent to 160 physicians (junior and senior grade) working at the emergency department of 12 hospitals in the Lyon region (France). Every participant had to estimate the true hospital costs of a selection of drugs, blood products, laboratory tests and imaging modalities.
  
  
  RESULTS
  One hundred and seven questionnaires (68%) were returned and analysed: 48 filled in by juniors (45%), 59 by seniors (55%). Only 26 physicians accurately estimated costs within 50% of the true cost. Response errors were underestimations averaging 4695±226euros, i.e. -59±3% of the total sum (7899euros). Drug prescriptions were significantly (P<0.001) the most underestimated (-74±3%), when compared to both imaging modalities (-23±5%) or blood products prescriptions (-37±6%). High-cost drugs (>1000euros) were the most overestimated pharmaceuticals (-82±2%). Laboratory tests were rather overestimated (+12±8%). Junior grade physicians underestimated more costs than senior physicians (P=0.04).
  
  
  CONCLUSIONS
  Physicians had a poor understanding of prescription costs at the emergencies, especially regarding high-cost drugs. Much progress is required to integrate the cost-containment problem in daily prescriptions at the emergency department.
authors: Hospices civils de Lyon, groupement hospitalier Édouard-Herriot, service de réanimation médicale, 69003 Lyon, France.
authors: Romain
authors: R
authors: Hernu
authors: Martin
authors: M
authors: Cour
authors: Geneviève
authors: G
authors: Causse
authors: Dominique
authors: D
authors: Robert
authors: Laurent
authors: L
authors: Argaud
mesh_terms: D000328:Adult; D001364:Awareness; D003365:Costs and Cost Analysis; D003625:Data Collection; D011307:Drug Prescriptions / Q000191:economics*; D004636:Emergency Service, Hospital / Q000191:economics*; D005260:Female; D005602:France; D017048:Health Care Costs / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D010820:Physicians / Q000191:economics*; D011795:Surveys and Questionnaires