保险拒绝和患者治疗在一个大型的学术辐射瘤中心
Jacob Y Shin1, Fumiko Chino1, John J Cuaron1
1Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, New York.
JAMA network open
|June 12, 2024
概括
大多数对放射治疗 (RT) 的保险拒绝得到批准,但有些导致治疗技术或剂量发生变化,可能会损害疗效. 在RT交付中也出现了延迟,影响了患者的护理.
科学领域:
- 在瘤学瘤学.
- 医疗保健服务研究 医疗服务研究
背景情况:
- 保险障碍严重负担癌症患者和临床医生.
- 支付者拒绝接受癌症治疗,包括放射治疗 (RT) 是一个越来越令人担忧的问题.
研究的目的:
- 调查保险拒绝对放射性瘤治疗的影响.
- 评估在保险授权问题后,RT技术,剂量和输送时间的变化.
主要方法:
- 一个单一机构对付款人拒绝RT授权的患者的队列分析.
- 从2021年11月到2022年12月收集的数据,分析到2023年12月.
- 使用千二测试进行统计分析,以评估结果.
主要成果:
- 在206个案例中,127个 (61.7%) 被批准没有变化.
- 56例 (27.2%) 需要修改RT技术或剂量.
- 72例病例 (34.9%) 经历了治疗延迟,平均7.8天.
结论:
- 虽然大多数对RT的保险拒绝最终得到批准,但付款人授权的变化可能会影响治疗的有效性.
- 显著的延误和修改凸显了保险拒绝对患者护理的负担.
- 需要进一步的研究来解决这些否认的临床和财务影响.
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