Utilization review and management: a brief analysis of a growth industry

Current evidence concerning the prevalence of inappropriate care indicates that there is an opportunity for significant utilization and cost reductions. Although the efficacy of some methods of utilization control has been demonstrated, the clinical impact and safety of these techniques are unclear. Although financial incentives have been successful in nonhealth industries, there is no evidence that fiscal rewards will eliminate inappropriate use rather than necessary care. Both short- and long-term quality assurance monitors should be combined with any utilization control method promoting "appropriate" use of inpatient beds and hospital services.