Navigation Links
1 million hours of psychiatrist time wasted yearly on phone approval for hospitalization

A study published today [Tuesday, April 23] in Annals of Emergency Medicine reports lengthy waits for severely ill psychiatric patients in need of immediate hospitalization in the Boston area, due in part to time-consuming prior authorizations required by insurance companies.

Psychiatrists spent, on average, 38 minutes on the telephone getting authorization. In 10 percent of cases it took more than one hour to obtain insurance authorization; in one case authorization took five hours of psychiatrist time.

Mental health disorders are common, affecting nearly 1 in 4 adults annually, less than a third of whom receive psychiatric care. Better access to care might reduce the harms mental illness imposes on the mentally ill, their families and communities.

For the present study, over a three-month period, researchers tabulated how long psychiatric patients who were deemed in need of inpatient admission stayed in the emergency department (ED) prior to being hospitalized, and the amount of time that the ED psychiatrists spent obtaining authorization from the patient's insurer. A group of 11 psychiatric residents at Cambridge Health Alliance (CHA) working in the psychiatric ED with acutely ill psychiatric patients collected the data.

Most patients required hospitalization because they were suicidal or, in a few cases, homicidal.

Although obtaining insurance authorization delayed care and took clinicians away from other duties, only 1 of the 53 requests for authorization was denied. Median total time in the ED was 8.5 hours, with the shortest stay lasting 3 hours and the longest recorded stay lasting 20 hours.

These numbers don't include a handful of patients who boarded in the ED over the weekend while waiting for an inpatient bed to become available for them. They exclude uninsured patients and those with Medicare, which doesn't require prior authorization.

With approximately 1.6 million psychiatric admissions among people with private insurance nationwide each year, 38 minutes of phone time to obtain authorization translates into about 1 million hours of wasted psychiatrist time.

Lead author Dr. Amy Funkenstein, a child psychiatry fellow at Brown University, led the study while she was a psychiatric resident at CHA and Harvard Medical School. She said: "Society pays for inadequate psychiatric care; more than half of all prison inmates and a third of all homeless people are mentally ill. Massachusetts is considered a model for health reform, yet we found that seriously ill patients routinely spent hours stranded in the ED due to insurance bureaucracy. The hours psychiatrists spend obtaining those authorizations could be far better spent treating our patients."

Senior author Dr. J. Wesley Boyd, attending psychiatrist at CHA and assistant clinical professor of psychiatry at Harvard Medical School, commented: "Private insurers are obstructing care by requiring authorizations before a qualified psychiatrist can hospitalize a dangerously ill patient. With doctors, nurses and emergency departments already overburdened, adding a time consuming bureaucratic task that doesn't help patients is unconscionable.

"Insurers hope that clinicians will be so hassled by authorization procedures that they won't seek admission for their patients, saving insurance companies money," he said. "Placing profits ahead of the health of patients when mental illness makes them vulnerable is immoral. A single-payer Medicare-for-all health care system would represent a great leap forward for patients and providers alike."


Contact: Mark Almberg
Physicians for a National Health Program

Related medicine news :

1. NIH awards $20 million over 5 years to train next generation of global health researchers
2. Scientist awarded $1 million grant to develop tools for hepatitis C treatment discovery
3. David H. Koch donates $10 million to Mount Sinais Jaffe Food Allergy Institute
4. $9 million grant awarded to UH to study, treat learning disabilities
5. New report shows 15 million babies born too soon every year
6. Southeast program to fight diabetes awarded nearly $10 million by HHS
7. OHSU study: Misdiagnosis of MS is costing health system millions per year
8. Enzyme corrects more than 1 million faults in DNA replication
9. 53 million Americans might have diabetes by 2025, according to a new study in Population Health Management
10. Asthma Cases Continue to Rise in U.S., Affecting Millions
11. UC San Diego Superfund Research Program receives $15 million grant renewal
Post Your Comments:
(Date:6/26/2016)... ... June 26, 2016 , ... PawPaws brand pet supplements ... was developed to enhance the health of felines. The formula is all-natural and is ... herbs in the PawPaws Cat Kidney Support Supplement Soft Chews are Astragalus ...
(Date:6/25/2016)... ... June 25, 2016 , ... Austin residents seeking Mohs ... College of Mohs Surgery and to Dr. Russell Peckham for medical and surgical dermatology. ... treatment for skin cancer. The selective fellowship in Mohs Micrographic Surgery completed by Dr. ...
(Date:6/25/2016)... , ... June 25, 2016 , ... As a lifelong ... Cum Laude and his M.D from the David Geffen School of Medicine at UCLA. ... to Los Angeles to complete his fellowship in hematology/oncology at the UCLA-Olive View-Cedars Sinai ...
(Date:6/24/2016)... , ... June 24, 2016 , ... A recent ... most people are unfamiliar with. The article goes on to state that individuals are ... many of these less common operations such as calf and cheek reduction. The Los ...
(Date:6/24/2016)... ... June 24, 2016 , ... ... Scientific Sessions in Dallas that it will receive two significant new grants to ... came as PHA marked its 25th anniversary by recognizing patients, medical professionals and ...
Breaking Medicine News(10 mins):
(Date:6/23/2016)... 2016 Any dentist who has made an implant ... process. Many of them do not even offer this as ... high laboratory costs involved. And those who ARE able to ... a high cost that the majority of today,s patients would ... Parsa Zadeh , founder of Dental Evolutions Inc. and inventor ...
(Date:6/23/2016)... LOS ANGELES , June 23, 2016 /PRNewswire/ ... (NASDAQ: CAPR ), a biotechnology company ... first-in-class therapeutics, today announced that patient enrollment in ... progrEssion in Duchenne) has exceeded 50% of its ... its enrollment in the third quarter of 2016, ...
(Date:6/23/2016)... the establishment of Astellas Farma Colombia (AFC), a new affiliate with operations headquartered in Bogota. Colombia ... ... Sandra ... ... Astellas is a pharmaceutical company ...
Breaking Medicine Technology: