Out of Pocket Costs for Dermatologic Surgical Procedures Not Associated with Patient Satisfaction

Yi MD, Nadir U, Hisham FI, Dave L, Maisel-Campbell A, Weil A, Poon E, Cahn BA, Pearlman R, Alam M. Association between out-of-pocket expense and patient satisfaction with cutaneous surgery: A prospective, randomized study. J Am Acad Dermatol. 2024 Mar;90(3):644-646. doi: 10.1016/j.jaad.2023.11.011. Epub 2023 Nov 18. PMID: 37981252.

The authors found no significant difference in patient satisfaction between patients who were aware of their out-of-pocket costs and those who were not. 

Clinical Pearls

• This prospective, single-center study by Yi et al investigated the potential relationship between out of pocket costs for cutaneous surgery and patient satisfaction scores              

• The authors found no significant difference in patient satisfaction between patients who were aware of their out-of-pocket costs and those who were not.                         

• This study has significant limitations in that its population was mostly white and had high educational attainment levels. Additionally, this study may not be generalizable to those of lower socioeconomic status, who may exhibit greater responses to out of pocket costs than their counterparts.

Discussion:

In this research letter published in the Journal of the American Academy of Dermatology, researchers from Northwestern University aimed to answer a frequently encountered question: Do out-of-pocket costs for dermatology procedures impact a patient’s satisfaction with their care? Thus, the authors performed a single-center, prospective study in which patient satisfaction was measured for a cohort of patients prior to receiving their bill (prebill) and to those who had received their bill (postbill).

There was data collected for 111 of the patients within the prebill cohort and 91 of those within the postbill cohort, and importantly, the authors found no significant difference in the mean out of pocket expense or procedure type between each cohort.

Overall, no significant difference in patient satisfaction score was found between the prebill and postbill cohort. Moreover, no significant correlation was seen between out-of-pocket expense and overall patient satisfaction or any specific patient satisfaction area. Although the authors findings are valuable, this study is limited in that its sample includes mostly highly-educated patients and those less likely to have a lower socioeconomic status. Which, consequently, may make their out-of-pocket costs less likely to have an influence on their experienced care. Nevertheless, the authors provide insight regarding a commonly encountered clinical question in dermatologic surgery.