Patient Care

Physicians, Residents, Students Can Learn High-Value, Cost-Conscious Care


Clinical question: What are the factors that promote education in delivering high-value, cost-conscious care?

Background: Healthcare costs are increasing, with most recent numbers showing U.S. expenditures on healthcare of more than $3 trillion, almost 18% of the gross domestic product. High-value care focuses on understanding the benefits, risks, and costs of care and promoting interventions that add value.

Study design: Systematic review.

Setting: Physicians, resident physicians, and medical students in North America, Asia, and Oceania.

Synopsis: Seventy-nine articles were included in the analysis, with 14 being RCTs. Most of the studies were conducted in North America (78.5%) and used a pre-post interventional design (58.2%). Practicing physicians (36.7%) made up the majority of participants in the study, with residents (15.2%) and medical students (6.3%) in smaller numbers. Analysis of the studies identified three factors for successful learning:

  • effective transmission of knowledge about prices of services and general health economics, scientific evidence, and patient preferences;
  • facilitation of reflective practice through feedback and/or stimulating reflection; and
  • creation of a supportive environment.

Bottom line: The most-effective interventions in educating physicians, resident physicians, and medical students on high-value, cost-conscious care are effective transmission of knowledge, reflective practice, and supportive environment.

Citation: Stammen LA, Stalmeijer RE, Paternotte E, et al. Training physicians to provide high-value, cost-conscious care: a systematic review. JAMA. 2015;314(22):2384-2400.

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