Purpose: To measure nonreimbursable, nonmedical costs incurred by patients attending a vitreoretinal clinic appointment.
Methods: A nurse-administered questionnaire designed to capture the nonmedical costs for a single clinical appointment was administered to patients attending an appointment at a single-center, single-physician, university-based vitreoretinal clinic. First day postoperative visits were excluded. End points were time commitment, time missing work, and median total nonmedical costs incurred. A subgroup analysis of Medicare patients who lived locally was performed.
Results: Three hundred and six patients completed the survey. The median nonreimbursable, nonmedical cost incurred was $23.32; the mean cost was $236.53 (range, $0-$7,259). The largest component of cost was transportation costs ($13.43). The patient took at least a day off from work in 27% cases. An accompanying person attended in 58%, and 27% took at least 1 day off from work to do so. The Medicare cohort who lived locally had similar median costs ($21.53); the mean cost was $51.29 (range, $0-$1,255.80). This cohort also had a lower incidence of missing work (6%), and a higher incidence of an accompanying person (68%) who had a lower incidence of missing work (16%). The costs and distributions varied minimally by visit type.
Conclusion: Physicians and policymakers may not recognize or consider the potential impediment to care that nonreimbursable costs may present when developing treatment strategies and designing policies.