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Utilization review. Emergency medicine implications.

L G Graff1

  • 1Section of Emergency Medicine, University of Connecticut School of Medicine, Farmington.

Emergency Medicine Clinics of North America
|August 1, 1992
PubMed
Summary
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Emergency medicine utilizes utilization review to control healthcare costs. Emergency department observation units and quality assurance committees help physicians implement cost-effective patient care strategies without compromising quality.

Area of Science:

  • Health Services Research
  • Emergency Medicine
  • Healthcare Management

Background:

  • Healthcare expenditures are a significant concern, prompting the medical profession to prioritize utilization review.
  • In emergency medicine, cost-containment strategies include limiting inappropriate visits, diagnostic testing, and hospital admissions.

Purpose of the Study:

  • To describe the role of emergency department observation units in implementing practice guidelines.
  • To highlight the function of the emergency department utilization review/quality assurance committee as a management tool for cost-effective care.

Main Methods:

  • Review of existing utilization review initiatives in emergency medicine.
  • Analysis of the operational framework of emergency department observation units.

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  • Examination of the functions of emergency department utilization review/quality assurance committees.

    • Main Results:

    • Emergency department observation units allow physicians to adhere to practice guidelines for cost control.
    • Utilization review and quality assurance committees serve as effective management tools for monitoring and implementing cost-effective patient care strategies.
    • These strategies can be implemented without compromising the quality of patient care.

    Conclusions:

    • Emergency department observation units and utilization review/quality assurance committees are vital for managing healthcare costs in emergency medicine.
    • Physician adherence to guidelines within these frameworks ensures cost-effective patient care.
    • The integration of utilization review practices supports financial sustainability in emergency departments.