SHM Converge Scientific Abstract ePoster Gallery-Teaching Cost-Conscious Care: A Needs-Based Curriculum to Improve Intern Understanding of Inpatient vs Outpatient Costs

Pdf Summary

This project describes a needs-based curriculum designed to teach interns cost-conscious, high-value care. The motivation was a significant gap in resident knowledge and confidence about cost-effective decision-making, especially around inpatient versus outpatient care. The authors note that up to 25% of U.S. healthcare spending is waste, amounting to an estimated $760–935 billion annually.<br /><br />To address this, the team developed three one-hour sessions delivered over three months. The curriculum covered: (1) an introduction to high-value care and its ethical dilemmas, (2) inpatient versus outpatient costs and discharge planning, and (3) barriers to high-value care and the cost of diagnostic imaging. A needs assessment guided the curriculum design.<br /><br />Results showed meaningful engagement and learning. Twenty-one interns submitted reflections, all 21 completed the post-session 2 survey, and 16 completed the post-session 3 survey. Knowledge improved in specific areas, including a 7% increase in correct identification of inpatient CBC cost differences and a 29% improvement in knowledge of Medicare skilled nursing facility coverage. Qualitative reflections showed that interns thought carefully about ethical tensions such as prolonged hospitalization versus outpatient follow-up, transportation barriers, insurance limitations, and balancing patient-centered care with resource use.<br /><br />Overall, the curriculum improved interns’ awareness of healthcare costs, ethical reasoning, and readiness to apply high-value care principles in clinical decision-making. The authors conclude that early, targeted education can help train residents to make more cost-conscious, patient-centered choices.

Asset Subtitle

Sarah Kosse

Meta Tag

Author List Ann Mercurio, Lindsey Fox, Sara Luby, Sarah Kosse, Vasundhara Singh

Category Research

Concept Cost

Concept High-Value Care

Concept Cost-Conscious Decision Making

Concept Skilled Nursing Facility

Concept Coverage Rules

Distinguished Non-Finalist

Presenter Organization Icahn School of Medicine at Mount Sinai Morningside/West

Presenting Author Sarah Kosse

Track Value in Hospital Medicine

Keywords

high-value care

cost-conscious care

medical education

intern curriculum

needs assessment

healthcare costs

inpatient versus outpatient care

ethical dilemmas

discharge planning

diagnostic imaging

Cost

High-Value Care

Cost-Conscious Decision Making

Skilled Nursing Facility

Coverage Rules