Knowing prices of surgical options influences choice

This article was originally published in the San Francisco Chronicle on September 24, 2014.

In the U.S. health care system, patients rarely know how much they’ll be charged for surgeries or hospital stays before they get the bill. But a new study from the University of Utah reveals that when patients and their families do get pricing information beforehand, they’re likely to make cost-conscious decisions about equal, but different treatments, even if the one they choose is not the doctor’s first choice.

Doctors at Primary Children’s Hospital in Utah treated 100 children who needed their appendix removed. Their parents were offered a choice between traditional open surgery or a laparoscopic procedure. Both types of surgery are considered equally safe and require similar amounts of time in the hospital, but doctors often prefer laparoscopies because they leave smaller scars and, in some cases, reduce the chance of infection.

In the study, parents of half the children received pricing information showing laparoscopies are significantly more expensive than open appendectomies. As a result, these parents were nearly twice as likely to choose the open surgery.

“Unlike other areas of the U.S. economy where it’s typical for people to compare prices before purchasing, health care consumers seldom know what they’ll pay for a procedure, meaning they have no basis for comparing costs,” Dr. Eric R. Scaife, the study’s senior author, said in a statement. “But our research found that when they have the information, consumers want to be in on health care decisions and that cost can influence what they choose when procedures are equally effective and have similar outcomes.”

Here are the numbers:


The percentage of parents who chose the less expensive open surgery after receiving pricing information for the open appendectomy surgery and the laparoscopy.


The percentage of parents who did not receive pricing information and chose open surgery.


The difference between the hospital’s average charges for the laparoscopy and the average charges for the open appendectomy.


The percentage of parents who received pricing information before choosing the open surgery and said price was the biggest factor in their decision. It was the most commonly cited reason. Other factors included number of incisions, past experience and influence from a health care provider outside the surgical team.


The percentage of parents who received pricing information before surgery said they liked having a choice between the two procedures.