title: Emergency physicians' knowledge of the total charges of medical care.
abstract: OBJECTIVE
  This study aimed to evaluate emergency medical physician's knowledge of the charges for the entirety of medical care provided to patients they treated and discharged from the emergency department (ED).
  
  
  METHODS
  The study was administered in an academic ED. Patients were eligible for the study if they were discharged from the ED by the attending who first evaluated them. Following patient discharge from the ED, the attending physician and resident were asked to estimate the total billed to the patient (all charges billed to patient before adjustments for insurance provider or coverage status were applied). The median error of the physician's estimate was compared to their years of experience.
  
  
  RESULTS
  Physicians underestimated actual total charges 93% (127/136) of the time. The median estimate was 36% (IQR 23%-54%) of the actual final ED charge, representing a median underestimation of $1268 (IQR $766-$2347). There was no correlation between degree of error and postgraduate years of the physician.
  
  
  CONCLUSIONS
  This study demonstrated a significant underestimation of a patient's total charges by emergency medical physicians. There was no correlation in years of experience and ability to accurately estimate charges. While all physicians tended to underestimate charges, physicians tended to have good inter-rater agreement.
authors.affiliation: Department of Emergency Medicine, Thomas Jefferson University and Hospitals, Philadelphia, PA 19107, USA. joseph.portale@jefferson.edu
authors.forename: Joseph V
authors.initials: JV
authors.lastname: Portale
authors.forename: Logan J
authors.initials: LJ
authors.lastname: Harper
authors.forename: J Matthew
authors.initials: JM
authors.lastname: Fields
mesh_terms: D000046:Academic Medical Centers; D000293:Adolescent; D000328:Adult; D000368:Aged; D003430:Cross-Sectional Studies; D004636:Emergency Service, Hospital / Q000191:economics; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D017722:Hospital Charges / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008505:Medical Staff, Hospital / Q000706:statistics & numerical data; D008875:Middle Aged; D010820:Physicians / Q000706:statistics & numerical data*; D014481:United States; D000078329:Workforce; D055815:Young Adult