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10271_Swenson
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The study aimed to determine the effect of a prior authorization policy on the prevalence and utilization of different routes of hysterectomy. The policy, implemented by a single private U.S. health insurer in April 2015, mandated prior authorization for all hysterectomies except outpatient vaginal procedures. The researchers analyzed data from a national private insurer, including 73 million enrollees, from January 2010 to June 2016. They identified hysterectomies using medical codes and compared the proportions and rates of different hysterectomy routes before and after the policy.<br /><br />Overall, the total number of hysterectomies decreased from 2010 to 2016, with a 51.6% decrease in inpatient procedures and a 73% increase in outpatient procedures. The analysis showed that the rates of change for some minimally invasive routes differed after the policy, but there was no change in abdominal hysterectomy rates. Outpatient vaginal hysterectomy rates continued to decline after the policy, but the rate of decline slowed. It is unclear whether the policy improved or changed outcomes.<br /><br />The researchers noted that factors other than healthcare policy may have contributed to the results, and they emphasized the importance of physicians continuing best-practices regardless of health insurance policies. They concluded that the prior authorization policy had an impact on the rates of different routes of hysterectomy, but further studies are needed to assess its overall effect on patient outcomes.
Keywords
effect
prior authorization policy
prevalence
utilization
routes of hysterectomy
private U.S. health insurer
outpatient vaginal procedures
data analysis
minimally invasive routes
abdominal hysterectomy rates
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