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Insurers Delay Hospitalization of Severely Ill Psychiatric Patients

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Hospitalization of severely ill psychiatric patients can be delayed because of authorization required by insurance companies, a study reported in the Annals of Emergency Medicine has found. The study was headed by Amy Funkenstein, M.D., a child psychiatry fellow at Brown University, and J. Wesley Boyd, M.D., an assistant clinical professor of psychiatry at Harvard Medical School. (Funkenstein and her colleagues conducted the study while she was a psychiatry resident at Harvard Medical School.) The study included 53 severely ill psychiatric patients in the Cambridge Health Alliance Psychiatric Emergency Department. Psychiatry residents tending to the patients averaged 38 minutes from the time of first contact with an insurance company until authorization to hospitalize the patients was either granted or denied. Although half the authorization requests took less than 20 minutes to be approved, for about 10 percent of patients authorization requests took an hour or more, with the longest request taking five hours.

"Private insurers are obstructing care by requiring authorizations before a qualified psychiatrist can hospitalize a dangerously ill patient," Boyd said in a press statement. "With doctors, nurses, and emergency departments already overburdened, adding a time-consuming bureaucratic task that doesn't help patients is unconscionable."

To read more about the challenges that emergency psychiatrists face in their work, see Psychiatric News here and here. Also see Clinical Manual of Emergency Psychiatry, from American Psychiatric Publishing.

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