Doctors who provide at least 10 hours of charity care per month tend to be better than other doctors at holding insured patients’ out-of-pocket costs down.

Researchers at the Center for Studying Health System Change, Washington, and the University of Chicago Hospitals, have published a study analyzing health system change center physician cost-efficiency survey data in the Archives of Internal Medicine.

Only 40% of doctors consider patient costs when deciding what diagnostic tests to recommend, and only 51% consider patient costs when deciding whether to treat a patient in the hospital or on an outpatient basis, the researchers report.

Although 46% of primary care doctors said they would consider patients’ out-of-pocket costs when choosing diagnostic tests, only 30% of the specialists who participated said they would take out-of-pocket costs into account, the researchers report.

When choosing care settings, 54% of the primary care doctors and 43% of the specialists said they would consider out-of-pocket costs.

Providing charity care had a smaller but significant effect on attitudes, the researchers report.

When choosing care settings, 51% of the doctors who provide at least 10 hours of charity care per month and only 48% of the doctors who provide no charity care said they would take patients’ out-of-pocket costs into consideration.

When choosing diagnostic tests, 41% of the charity care doctors and 36% of the doctors providing no charity care said they would think about patients’ costs, the researchers report.