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关于先进肩部成像的预先授权率和影响

Haley N Tornberg¹, Aine M Gallahue¹, Alison M Blumstein²

¹Cooper Medical School of Rowan University, Camden, NJ, USA.

Journal of shoulder and elbow surgery

|August 21, 2025

概括

肩部核磁共振的预先授权 (PA) 造成了护理的障碍,拒绝受到种族,提供者类型和保险公司的影响,而不仅仅是计划类型. 这些拒绝可能会推迟必要的医疗干预,

科学领域:

放射学
医疗服务研究
医学经济学

背景情况:

肩部疼痛是不同的人群中普遍存在的疾病.
磁共振成像 (MRI) 对于诊断肩部疾病至关重要.
提前授权 (PA) 造成了肩部MRI的重大障碍,增加了行政负担和成本.

研究的目的:

检查肩部MRI的先前授权的趋势.
调查PA拒绝与患者人口统计,提供者类型和保险特征之间的关联.

主要方法:

从2021年12月到2023年9月对需要PA的肩部MRI进行回顾.
人口统计分析,诊断,提供者专业,保险公司和第三方授权公司.
基平方和逻辑回归分析以确定与PA否定相关的因素.

主要成果:

在包括的2,499个肩膀MRI中,有5.8%被拒绝.
非骨科提供者 (OR=4.38) 和非裔美国人和西班牙裔患者的订单面临更高的拒绝率.
根据第三方授权公司 (P < .001) 和主要付款人 (P < .001) 的不同,商业保险的拒绝率高于医疗保险D部分.

结论:

肩部MRI的拒绝率受到包括种族,提供者专业和保险/TPA公司在内的复杂因素的相互作用的影响.
拒绝的可能性似乎更多地取决于特定的保险公司或TPA公司,而不是保险类型本身.
低拒绝率 (5.8%) 质疑PA的整体效用,这可能会给医疗保健系统带来延误和额外的成本.

关键词:

核磁共振成像预先授权 (PA)获得肩部护理拒绝率保险公司肩部疼痛

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