Assessing the financial burden on patients and their households attending hospital clinics: a pilot cross-sectional study
Bibliographic record
Abstract
BACKGROUND: The financial burden on patients in terms of private out-of-pocket personal costs related to accessing healthcare services has become a growing concern internationally. While healthcare systems and access arrangements differ internationally, private cost to patients and their households remains an under-researched area. The private out-of-pocket costs of attending hospital outpatient consultations in Ireland has not been previously established. METHODS: We developed a data collection tool to measure the private costs to patients of attending hospital outpatient consultations. Resource items included travel time and expenses, missed work, need for accompanying carers, and care needs for dependents, in addition to demographic details. In the pilot study, the questionnaire was completed by 42 patients attending several hospital outpatient departments in a large teaching public hospital in the west of Ireland. RESULTS: The pilot study demonstrated the questionnaire’s feasibility and acceptability. Estimates of private costs per visit showed considerable variability, with a median cost per patient of €131 (Inter Quartile Range €142; range €22-€370). Participants reported attending on average 4 appointments per year (mean 4.26, range 1–20, SD 3.7), giving a mean annual cost of attending hospital clinics of €559 per person. On average, participants spent 1.2 h (range 0.1-3.0) travelling to their appointment. Fourteen participants (33%) reported missing work, while 18 (43%) required an accompanying carer, of whom four carers were paid. CONCLUSIONS: Private costs related to attending outpatient clinics are not insignificant. Formal validation of the data collection tool is required, alongside further studies involving larger, more diverse participant samples to better quantify the financial implications for patients attending outpatient consultations. REGISTRATION: The study protocol was pre-registered using the Center for Open Science registration portal (08 March 2024).
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.004 | 0.004 |
| Meta-epidemiology (narrow) | 0.000 | 0.001 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.003 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".