The Role of Health Care Costs in Understanding Patient Preferences of Providers

• Health care
• Cost
• Patient preference

Editor – Kraus and colleagues¹ administered a 28-question survey to new patients who were referred to the foot and ankle service in an orthopedic department.The survey assessed patient opinion and knowledge of the difference between doctors of podiatric medicine and orthopedic surgeons. The investigators assessed multiple potential predictor variables including age, personal or professional connection with the healthcare field, previous care by a podiatrist, level of education, and knowledge of differences between a podiatrist and orthopedic surgeon. The investigators found patients have poor understanding of the different provider training between a podiatrist and orthopedic surgeon. Those patients that demonstrated a higher level of knowledge of the specialties were more likely to prefer an orthopedic surgeon. The investigators did not assess the potential role of financial factors in driving patient preferences of providers. Co-pays and other out-of-pocket expenses may differ between care provided by a podiatrist and an orthopedic surgeon, and/or patients may perceive there is a difference. These differences may influence patients’ health care choices, including provider selection.

In the 2020 National Health Interview Survey, 1 in 11 adults reported delaying or going without medical care due to cost reasons.² In another analysis, 46% of insured adults reported difficulty affording their out-of-pocket costs, and 27% reported difficulty affording their deductible.³ Future analyses seeking to understand patient preferences of health care professionals should assess out-of-pocket costs to patients and patients’ perceptions regarding cost of care and how those variables might predict patients’ provider preferences.

• Received April 28, 2022.
• Accepted May 10, 2022.