Department of Dermatology, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, USA.
Dermatol Online J. 2021 Jan 15;27(1):13030/qt990631n9.
Completing prior authorizations (PAs) can be a lengthy process, which can delay access to appropriate care. A 2017 American Academy of Dermatology survey highlighted that PAs are common across many dermatologic medication classes. However, little is known regarding the impact of PAs on patient care and resource use.
To better characterize the burden of PAs on dermatology practices and their effects on patient care, a survey was conducted in February 2020 among U.S.-based dermatologists (N=3,000) and the Association of Dermatology Administrators/Managers (ADAM) members (N=718).
Respondents reported 24% of patients require PAs. Dermatologists and staff spend a mean of 3.3 hours/day on PAs. Sixty percent of dermatologists reported interrupting patient visits for PAs. Sixty-five percent respondents reported PAs were required for clobetasol, 76% for tretinoin, and 42% for 5-fluorouracil. Respondents noted 45% of PA determinations took beyond one week and 17% took beyond two weeks. Respondents reported 12% of PAs resulted in delaying or abandoning treatment and 17% resulted in less appropriate treatment.
Prior authorization burden remains high and consumes substantial clinical resources, which may negatively impact patient care. Additionally, they result in prolonged treatment delays and are associated with delaying treatment, abandoning treatment, or using lesser treatment.
完成预先授权（PA）可能是一个漫长的过程，这可能会延迟获得适当的治疗。美国皮肤病学会 2017 年的一项调查强调，许多皮肤科药物都需要进行 PA。然而，对于 PA 如何影响患者的护理和资源使用，人们知之甚少。
为了更好地描述 PA 对皮肤科实践的负担及其对患者护理的影响，于 2020 年 2 月对美国皮肤科医生（n=3000）和皮肤科管理人员协会（ADAM）成员（n=718）进行了一项调查。
受访者报告称，24%的患者需要 PA。皮肤科医生和工作人员每天在 PA 上花费 3.3 小时。60%的皮肤科医生报告说，他们为了 PA 而中断了患者的就诊。65%的受访者报告说，需要为卤倍他索、76%为维 A 酸、42%为 5-氟尿嘧啶开具 PA。受访者指出，45%的 PA 决定需要超过一周的时间，17%的 PA 需要超过两周的时间。受访者报告称，12%的 PA 导致治疗延迟或放弃，17%的 PA 导致治疗不恰当。
预先授权的负担仍然很高，消耗了大量的临床资源，这可能会对患者的护理产生负面影响。此外，它们还导致治疗延迟，并与延迟治疗、放弃治疗或使用较少的治疗有关。
