Freelisting on Costs and Value in Health Care by Pediatric Attending Physicians

In Academic Pediatrics, Evan Fieldston and colleagues assessed pediatricians’ perceptions about the concepts of “costs” and “value” as part of curriculum development on the subject. An online survey asked physicians at the Children’s Hospital of Philadelphia to generate a list of words that came to mind when thinking about “costs” and “value” and topics to include in a curriculum. More than 200 physicians generated a list of topics through this freelisting exercise, and those topics were ranked for their salience, or relative importance. The most salient term for the cost prompt, by a wide margin, was “excessive”. For value, the most salient responses were “outcomes” and “quality.” For elements to include in a curriculum, the most salient responses were “insurance” and “costs”. Overall, there was general agreement that health care costs are “excessive,” that “outcomes” and “quality” are integral to value, and that there is a need for education in these areas, especially around “insurance.”