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预先授权审查对骨科子专业护理的影响:一个前性的多中心分析

Claudius D Jarrett¹, Alexander Dawes², Mina Abdelshahed³

¹Wilmington Health Orthopaedics and Sports Medicine, Wilmington, NC, USA.

Journal of shoulder and elbow surgery

|November 22, 2023

概括

骨科护理的先前授权审查 (PAR) 的拒绝率很低,但造成了巨大的行政负担和延误. 这一过程可能没有增加价值,并对患者及时获得护理的机会产生负面影响.

科学领域:

整形外科整形外科整形外科
医疗保健服务研究医疗服务研究
卫生政策卫生政策

背景情况:

预先授权审查 (PAR) 已经扩展到不仅仅是住院治疗,还包括例行治疗和成像.
PAR对骨科子专业护理的影响尚不清楚.
这项研究研究了PAR对骨科子专业实践的影响.

研究的目的:

调查骨科子专业护理中PAR的拒绝率.
量化PAR造成的护理延迟的持续时间.
评估PAR对骨科实践的行政负担.

主要方法:

一项前性的多中心研究,涉及6个州的骨科肩部和体育子专业实践.
监控常规患者护理的付款人授权的PAR,记录保险公司,位置,批准/拒绝率和行政时间.
评估了1065个PAR请求,以确定结果和资源使用情况.

主要成果:

观察到高级成像或手术的整体PAR拒绝率为1.5%.
商业和医疗补助保险的拒绝率高于传统的医疗保险或政府支付者.
每个PAR的平均管理时间为19.5分钟,患者需要等待2.2天才能获得初步批准;一些上诉需要超过30天.

结论:

骨科子专业护理的PAR在很大程度上得到了批准,但造成了巨大的行政负担和延误.
目前的PAR流程似乎是不必要的,增加了成本,并对患者的访问产生了负面影响.
由于其可疑的价值和对护理及时性的负面影响,应该在基于价值的护理背景下重新评估PAR.

关键词:

进行事先授权审查.行政负担管理负担.获得医疗保健的机会.医疗保健的质量.下一篇:子专业护理护理基于价值的护理是基于价值的.

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