title: Understanding the cost of dermatologic care: A survey study of dermatology providers, residents, and patients.
abstract: BACKGROUND
  The American Academy of Dermatology recommends dermatologists understand the costs of dermatologic care.
  
  
  OBJECTIVE
  This study sought to measure dermatology providers' understanding of the cost of dermatologic care and how those costs are communicated to patients. We also aimed to understand the perspectives of patients and dermatological trainees on how cost information enters into the care they receive or provide.
  
  
  METHODS
  Surveys were systematically developed and distributed to 3 study populations: dermatology providers, residents, and patients.
  
  
  RESULTS
  Response rates were over 95% in all 3 populations. Dermatology providers and residents consistently underestimated the costs of commonly recommended dermatologic medications but accurately predicted the cost of common dermatologic procedures. Dermatology patients preferred to know the cost of procedures and medications, even when covered by insurance. In this population, the costs of dermatologic medications frequently interfered with patients' ability to properly adhere to prescribed regimens.
  
  
  CONCLUSIONS
  The surveyed population was limited to the northwestern United States and findings may not be generalizable. Cost estimations were based on average reimbursement rates, which vary by insurer.
  
  
  CONCLUSIONS
  Improving dermatology providers' awareness and communication of the costs of dermatologic care might enhance medical decision-making, improve adherence and outcomes, and potentially reduce overall health care expenditures.
authors.affiliation: Geisel School of Medicine, Dartmouth College, Hanover, New Hampshire; Department of Medicine, Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire.
authors.forename: Aaron J
authors.initials: AJ
authors.lastname: Steen
authors.affiliation: Geisel School of Medicine, Dartmouth College, Hanover, New Hampshire; Department of Dermatology, Oregon Health & Science University, Portland, Oregon; Division of Dermatology, Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire.
authors.forename: Julianne A
authors.initials: JA
authors.lastname: Mann
authors.affiliation: Department of Dermatology, Oregon Health & Science University, Portland, Oregon; Department of Dermatology, Massachusetts General Hospital, Boston, Massachusetts; Harvard Medical School, Boston, Massachusetts.
authors.forename: Valerie M
authors.initials: VM
authors.lastname: Carlberg
authors.affiliation: Department of Dermatology, Massachusetts General Hospital, Boston, Massachusetts; Harvard Medical School, Boston, Massachusetts.
authors.forename: Alexa B
authors.initials: AB
authors.lastname: Kimball
authors.affiliation: Department of Mathematics, Dartmouth College, Hanover, New Hampshire.
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Musty
authors.affiliation: Department of Dermatology, Oregon Health & Science University, Portland, Oregon. Electronic address: Simpsone@ohsu.edu.
authors.forename: Eric L
authors.initials: EL
authors.lastname: Simpson
mesh_terms: D000328:Adult; D003657:Decision Making; D003879:Dermatologic Agents / Q000191:economics; D003880:Dermatology / Q000191:economics*; D005260:Female; D017048:Health Care Costs; D019538:Health Care Surveys; D006801:Humans; D019458:Insurance Coverage; D007349:Insurance, Health, Reimbursement; D007396:Internship and Residency; D008297:Male; D008875:Middle Aged; D015205:Northwestern United States; D010349:Patient Compliance; D010361:Patients / Q000523:psychology; D010817:Physician-Patient Relations; D010820:Physicians / Q000523:psychology; D011306:Prescription Fees; D011364:Professional Practice; D012871:Skin Diseases / Q000175:diagnosis / Q000191:economics* / Q000628:therapy; D014342:Truth Disclosure
chemical_list: D003879:Dermatologic Agents
keywords: cost awareness; cost estimation; cost of care; high-value healthcare