Background: With growing emergency department visits, there has been a growth in national health expenditure. This situation is exacerbated by physicians ordering ineffective investigations and procedures. This study aimed to assess the emergency physician’s awareness of the cost of diagnostic tests and interventions, and how awareness of costs may impact their medical decision. Methods: This cross-sectional study was conducted among emergency physicians in Saudi Arabia. The data were collected via a self-administered questionnaire disseminated through emails to all physicians. Results: A total of 233 physicians participated, the majority of whom were males (73%) and aged 24-34 years old (70.8%). Of the included physicians, 41.2% were junior residents, and three-quarters (75.5%) of the respondents had never worked in private hospitals. Two-thirds of respondents agreed/strongly agreed that knowing financial cost would affect their clinical practice. Physicians tended to overestimate the cost of drugs while underestimating the cost of diagnostics and laboratory tests. The percentage of correct estimates was higher for diagnostics and laboratory (<30%), it was markedly higher than for drugs (9%). The effect of cost information showed a reduction in the median overall costs for the laboratories requested while there was no significant reduction in the costs of diagnosis and drugs. While in other scenarios, there was no significant reduction in the overall costs of drugs, laboratories, and diagnostics. Conclusion: Our study highlights the importance of cost awareness among emergency physicians and demonstrates that increased cost awareness could potentially influence medical decision making.

Keywords: Economics, cost savings, cost-effectiveness analysis, health expenditures.