预先授权和对护理连续性的不利影响
1Department of Political Science, Auburn University, 7080 Haley Center, Auburn, AL 36849.
The American journal of managed care
|April 14, 2025
概括
预先授权 (PA) 程序导致患者护理的重大延迟和治疗的放弃. 许多医生正在转向现金模式,以获得更大的自主性和透明度.
科学领域:
- 卫生政策 卫生政策
- 医学经济学 医学经济学
- 患者倡导 患者倡导
背景情况:
- 目前的预先授权 (PA) 系统为及时的患者护理创造了巨大的障碍.
- 导航医疗治疗的保险批准与严重的患者痛苦和财务负担有关.
研究的目的:
- 批判性地检查事先授权程序对患者护理和提供者工作流程的不利影响.
- 探索越来越多的医生实践采用现金模式的趋势,以应对PA的挫折.
主要方法:
- 本评论分析了现有数据,并报告了事先授权的影响.
- 它审查了PA对患者和医疗保健提供者的行政和财务负担.
- 它讨论了对替代实践模式的转变,以应对这些挑战.
主要成果:
- 94%的患者经历了护理延迟,78%的患者由于事先授权要求而放弃治疗.
- 预先授权流程往往需要在批准必要的治疗之前尝试替代疗法,这会影响重症监护.
- 保险公司的行政负担耗费了大量的提供者时间,而保险公司则报告了创纪录的利.
结论:
- 预先授权系统对患者的治疗结果产生了负面影响,并增加了医疗保健成本.
- 现金诊所的兴起提供了一个潜在的解决方案,增强医生自主权和患者价格透明度.
- 解决PA的低效率对于改善医疗保健中的患者和提供者体验至关重要.
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