title: Portuguese Family Physicians' Awareness of Diagnostic and Laboratory Test Costs: A Cross-Sectional Study.
abstract: BACKGROUND
  Physicians' ability to make cost-effective decisions has been shown to be affected by their knowledge of health care costs. This study assessed whether Portuguese family physicians are aware of the costs of the most frequently prescribed diagnostic and laboratory tests.
  
  
  METHODS
  A cross-sectional study was conducted in a representative sample of Portuguese family physicians, using computer-assisted telephone interviews for data collection. A Likert scale was used to assess physician's level of agreement with four statements about health care costs. Family physicians were also asked to estimate the costs of diagnostic and laboratory tests. Each physician's cost estimate was compared with the true cost and the absolute error was calculated.
  
  
  RESULTS
  One-quarter (24%; 95% confidence interval: 23%-25%) of all cost estimates were accurate to within 25% of the true cost, with 55% (95% IC: 53-56) overestimating and 21% (95% IC: 20-22) underestimating the true actual cost. The majority (76%) of family physicians thought they did not have or were uncertain as to whether they had adequate knowledge of diagnostic and laboratory test costs, and only 7% reported receiving adequate education. The majority of the family physicians (82%) said that they had adequate access to information about the diagnostic and laboratory test costs. Thirty-three percent thought that costs did not influence their decision to order tests, while 27% were uncertain.
  
  
  CONCLUSIONS
  Portuguese family physicians have limited awareness of diagnostic and laboratory test costs, and our results demonstrate a need for improved education in this area. Further research should focus on identifying whether interventions in cost knowledge actually change ordering behavior, in identifying optimal methods to disseminate cost information, and on improving the cost-effectiveness of care.
authors.affiliation: Family Medicine Unit, Social Sciences and Health Department of the Faculty of Medicine of Porto, Porto, Portugal; Family Health Unit Nova Via, Porto, Portugal.
authors.forename: Luísa
authors.initials: L
authors.lastname: Sá
authors.affiliation: Centre for Research in Health Technologies and Information Systems (CINTESIS) and Information Sciences and Decision on Health Department (CIDES), Faculty of Medicine, University of Porto, Porto, Portugal Al. Prof. Hernâni Monteiro 4200-319 Porto, Portugal.
authors.forename: Cristina
authors.initials: C
authors.lastname: Costa-Santos
authors.affiliation: Centre for Research in Health Technologies and Information Systems (CINTESIS) and Information Sciences and Decision on Health Department (CIDES), Faculty of Medicine, University of Porto, Porto, Portugal Al. Prof. Hernâni Monteiro 4200-319 Porto, Portugal.
authors.forename: Andreia
authors.initials: A
authors.lastname: Teixeira
authors.affiliation: Family Medicine Unit, Social Sciences and Health Department of the Faculty of Medicine of Porto, Porto, Portugal.
authors.forename: Luciana
authors.initials: L
authors.lastname: Couto
authors.affiliation: Centre for Research in Health Technologies and Information Systems (CINTESIS) and Information Sciences and Decision on Health Department (CIDES), Faculty of Medicine, University of Porto, Porto, Portugal Al. Prof. Hernâni Monteiro 4200-319 Porto, Portugal.
authors.forename: Altamiro
authors.initials: A
authors.lastname: Costa-Pereira
authors.affiliation: Family Medicine Unit, Social Sciences and Health Department of the Faculty of Medicine of Porto, Porto, Portugal.
authors.forename: Alberto
authors.initials: A
authors.lastname: Hespanhol
authors.affiliation: Family Medicine Unit, Social Sciences and Health Department of the Faculty of Medicine of Porto, Porto, Portugal; Centre for Research in Health Technologies and Information Systems (CINTESIS) and Information Sciences and Decision on Health Department (CIDES), Faculty of Medicine, University of Porto, Porto, Portugal Al. Prof. Hernâni Monteiro 4200-319 Porto, Portugal.
authors.forename: Paulo
authors.initials: P
authors.lastname: Santos
authors.affiliation: Family Medicine Unit, Social Sciences and Health Department of the Faculty of Medicine of Porto, Porto, Portugal; Centre for Research in Health Technologies and Information Systems (CINTESIS) and Information Sciences and Decision on Health Department (CIDES), Faculty of Medicine, University of Porto, Porto, Portugal Al. Prof. Hernâni Monteiro 4200-319 Porto, Portugal.
authors.forename: Carlos
authors.initials: C
authors.lastname: Martins
mesh_terms: D000328:Adult; D000368:Aged; D019411:Clinical Laboratory Techniques / Q000191:economics*; D003430:Cross-Sectional Studies; D003710:Demography; D019937:Diagnostic Techniques and Procedures / Q000191:economics*; D005260:Female; D017048:Health Care Costs; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008297:Male; D008875:Middle Aged; D010821:Physicians, Family; D011174:Portugal; D011320:Primary Health Care / Q000191:economics; D055815:Young Adult