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Updated: Feb 12, 2026

Measurements of Motor Function and Other Clinical Outcome Parameters in Ambulant Children with Duchenne Muscular Dystrophy
Published on: January 12, 2019
Clinical and fiscal outcomes of utilization review
Mary Ellen Murray1, Julie V Darmody
1School of Nursing, University of Wisconsin-Madison, K6/340 Clinical Science Center, 600 Highland Avenue, Madison, WI 53792, USA. memurra1@facstaff.wisc.edu
Abstract:
Concurrent utilization review (UR) is both a quality improvement tool and a cost containment strategy used by managed care organizations. The UR process requires that providers (hospital staff) communicate clinical information about hospitalized patients to payers who evaluate the appropriateness and medical necessity of the planned care. Payers then make a decision whether to certify the care for reimbursement. This study provides data to indicate that denials of certification have little impact on clinical and fiscal outcomes of patient care.
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