J Drugs Dermatol. 2024 Jun 1;23(6):485-488. doi: 10.36849/JDD.7617.
Prior authorizations (PAs) are administrative tasks commonly required by insurers to approve medications or therapies for patients. Dermatology practices frequently employ coordinators to focus on completing PAs, among other solutions. The degree to which this support is offered in academic centers and, importantly, how much time dermatology residents spend on PAs over educational pursuits is largely unknown. The authors sought to identify the impact of PAs on dermatology residents.
An IRB-approved (#NCR213814) 13-question survey was distributed nationwide to dermatology residents regarding the impact of PAs on aspects of clinical and scholarly activities. Results: 150 of 1462 dermatology residents, 10.3%, responded to the survey. 70% of responding residents contribute to obtaining PAs. 58.7% indicated that their program employed a PA coordinator; though, of these, 63.6% still relied on residents for PAs. 84% indicated that for the following month they feared the burden of PAs would lead to a lapse in treatment for patients. 72.7% avoided prescribing certain medications due to PAs. 64% indicated the PA burden impedes their ability to perform scholarly activities. 80.7% indicated the PA burden contributed to burnout or decreased morale.
Our data highlight that dermatology residents are negatively impacted by the burden of PAs, resulting in reduced time to study, research, and best care for their patients. Dermatology residents and patients would benefit from reducing the burden of PAs, especially on residents by reforms or regulations that reduce dermatologic PAs, or by academic institutions removing these responsibilities from residents as best as possible. Drugs Dermatol. 2024;23(6):485-488. doi:10.36849/JDD.7617.
预先授权（PA）是保险公司为患者批准药物或治疗方案通常需要执行的行政任务。皮肤科实践中经常聘请协调员来专门完成 PA，以及其他解决方案。在学术中心提供这种支持的程度，以及皮肤科住院医师在教育追求上花费多少时间来完成 PA，在很大程度上是未知的。作者旨在确定 PA 对皮肤科住院医师的影响。
在全国范围内向皮肤科住院医师分发了一份经过机构审查委员会批准的（#NCR213814）包含 13 个问题的调查，以了解 PA 对临床和学术活动各个方面的影响。结果： 1462 名皮肤科住院医师中有 150 名（10.3%）对调查做出了回应。70%的应答住院医师参与获得 PA。58.7%表示他们的项目雇用了 PA 协调员；然而，其中 63.6%仍依赖住院医师完成 PA。84%表示，在接下来的一个月里，他们担心 PA 的负担会导致患者的治疗中断。72.7%因 PA 而避免开某些药物。64%表示 PA 的负担会影响他们开展学术活动的能力。80.7%表示 PA 的负担导致他们精疲力竭或士气低落。
我们的数据强调，PA 的负担对皮肤科住院医师产生了负面影响，导致他们用于学习、研究和为患者提供最佳护理的时间减少。减少 PA 的负担，特别是减少住院医师的负担，无论是通过改革或法规减少皮肤科 PA，还是通过学术机构尽可能从住院医师身上移除这些责任，都将使皮肤科住院医师和患者受益。皮肤病药物杂志。2024;23(6):485-488。doi:10.36849/JDD.7617.
