在癌症患者的先前授权方面存在种族和民族差异
Benjamin Ukert1, Stephanie Schauder, Daniel Cullen
1Public Policy Institute, Elevance Health, Indianapolis, IN.
The American journal of managed care
|October 28, 2024
概括
癌症护理事先授权 (PA) 显示,黑人和西班牙裔患者没有种族差异. 与白人患者相比,亚洲患者经历的PA拒绝较少,这表明公平的治疗机会.
科学领域:
- 在瘤学瘤学.
- 医疗保健服务研究 医疗服务研究
- 健康 公平 卫生 公平
背景情况:
- 预先授权 (PA) 是医疗保健中的一个关键过程,以确保治疗与医疗必要性保持一致.
- 在不同患者群体中评估PA决策对于识别和解决潜在的健康不平等至关重要.
- 癌症护理往往涉及复杂的治疗途径,需要PA,这使得它成为研究获取差异的关键领域.
研究的目的:
- 调查癌症患者事先授权 (PA) 决策中的潜在种族和民族差异.
- 分析PA结果,包括基于癌症的商业保险人群的种族和种族的拒绝率.
主要方法:
- 在2017年1月至2020年4月期间诊断的18,041名商业保险癌症患者的回顾性分析.
- 利用纵向保险数据来检查种族/民族组成和PA过程结果.
- 采用线性回归模型来评估跨种族和族群的PA结果差异.
主要成果:
- 研究样本包括85%的白人,10%的黑人,3%的亚洲人和1%的西班牙裔患者.
- 总体而言,事先授权拒绝率为10%,其中5%归因于缺乏医疗必要性.
- 西班牙裔患者的拒绝率最高 (12%),而黑人患者的拒绝率最低 (8%);然而,回归分析发现这些群体与白人患者相比没有显著差异. 亚洲患者的拒绝率低于白人患者.
结论:
- 与白人患者相比,在黑人和西班牙裔癌症患者的先前授权 (PA) 结果中没有发现显著的种族或种族差异.
- 亚洲患者表现出更高的PA批准率,这表明潜在的更简单的访问.
- 这些发现有助于理解癌症护理中的PA过程,并强调需要持续监测健康公平.
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