Renee Hsia ’99’s latest research paper was sparked by a seemingly simple question from a friend who had been poring over his hospital bills: What is the typical cost of an appendectomy?
Hsia, an assistant professor at the University of California, San Francisco, and emergency-medicine physician, could not give an answer. But she eventually culled the data from a statewide database of health charges: The median fees to treat “uncomplicated” appendicitis totaled $33,611 – and depending on where a patient went for the procedure, it could cost anywhere from $1,529 to $182,955.
“The fact that there’s variation is not surprising,” Hsia told PAW. “But the range was surprising, even to me.”
Hsia and three co-authors published their findings in the journal Archives of Internal Medicine, and the study drew national media attention last week, with coverage from ABC News, The New York Times, the Associated Press, and others.
While the wildly disparate fees captured the headlines, Hsia said there were other lessons from the research, including one that she observes in her emergency-room shifts. When you’re suffering from something like severe abdominal pain, you’re not exactly in a position to shop around, but the unpredictable costs of health care “make patients fearful to be admitted,” she said.
The problem is most pressing for those with no insurance or subpar coverage, but Hsia adds that even patients with good insurance often pay hefty out-of-pocket fees and can be affected by health-care inefficiencies, which drive up premiums.
Hsia, a Harvard Medical School graduate who also received a master’s degree from the London School of Economics/London School of Hygiene and Tropical Medicine, divides her time between research, clinical work, and teaching. She studies inefficiency and inequity in health care, areas of interest that have roots in her undergraduate courses at Princeton’s Woodrow Wilson School, where she learned about public policy from the likes of Uwe Reinhardt, Stan Katz, and Lynn White. Hsia shared the Pyne Prize, the University’s highest undergraduate honor, in her senior year at Princeton.
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