在办公室实验室环境中,事先授权的要求在行政上是低效的,并威胁到护理的及时性
Keerthi B Harish1, Ethan Chervonski1, Giancarlo Speranza1
1New York University Grossman School of Medicine, New York, NY.
Journal of vascular surgery
|December 22, 2023
概括
办公室实验室 (OBL) 的事先授权 (PA) 影响程序,许多拒绝在上诉中被推翻. 虽然行政繁重,但PA上诉成功地扭转了大多数对OBL干预的最初拒绝.
科学领域:
- 血管外科 血管外科
- 医疗保健服务研究 医疗服务研究
- 医疗保健管理局的管理.
背景情况:
- 预先授权 (PA) 是医疗程序的常见要求.
- 在办公室实验室 (OBL) 设置中PA的行政和临床负担没有得到很好的描述.
研究的目的:
- 在办公室实验室 (OBL) 环境中调查事先授权 (PA) 流程的行政和临床影响.
主要方法:
- 从2018年1月到2022年3月,对需要PA的OBL程序进行回顾性分析.
- 从实践安排数据库中提取的数据,包括案例,PA和编码信息.
主要成果:
- 在1854例OBL病例中,8%需要PA,主要用于下肢动脉 (75%) 和深静脉 (19%) 的干预.
- 19%的PAs最初被拒绝,但在上诉后,74%被推翻. 深静脉手术的拒绝率 (43.8%) 比动脉手术 (11.8%) 高.
- 4%的手术由于悬而未决的PA延迟了平均14.2天;在终端拒绝后,在实践成本下进行了4项手术.
结论:
- 在OBL中,事先授权流程存在行政挑战.
- 投诉机制有效地推翻了最初的PA拒绝,减轻了临床影响.
- 尽管存在行政负担,但利用PA上诉对于患者获得OBL中必要的干预措施至关重要.
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