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The utilization review program. Essential for hospital survival.

J J Castillo1, K E Bennett

  • 1Coral Gables Hospital, FL 33134.

Quality Assurance and Utilization Review : Official Journal of the American College of Utilization Review Physicians
|February 1, 1989
PubMed
Summary
This summary is machine-generated.

A robust utilization review program is crucial for healthcare institution survival. This guide outlines developing an integrated program with administrative and staff support for economic stability.

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Area of Science:

  • Healthcare Administration
  • Health Economics

Background:

  • Healthcare institutions face economic challenges impacting survival.
  • Efficient operations, particularly utilization review, are vital for financial viability.

Purpose of the Study:

  • To provide a guideline for developing an effective utilization review program.
  • To emphasize the essential role of utilization review in healthcare economics.

Main Methods:

  • Developing an integrated organizational structure for utilization review.
  • Ensuring administrative support and participation from physicians and key hospital departments.
  • Implementing educational programs for physicians on patient management and economic impact.

Main Results:

  • A well-structured utilization review program enhances institutional economic survival.
  • Collaboration between utilization review, medical staff, and administration is key.
  • Physician education on prospective payment systems improves patient management and economic outcomes.

Conclusions:

  • An integrated utilization review program is fundamental for healthcare financial health.
  • Continuous physician education and interdepartmental cooperation are necessary for sustained economic performance.