Jove
Visualize
Contact Us
JoVE
x logofacebook logolinkedin logoyoutube logo
ABOUT JoVE
OverviewLeadershipBlogJoVE Help Center
AUTHORS
Publishing ProcessEditorial BoardScope & PoliciesPeer ReviewFAQSubmit
LIBRARIANS
TestimonialsSubscriptionsAccessResourcesLibrary Advisory BoardFAQ
RESEARCH
JoVE JournalMethods CollectionsJoVE Encyclopedia of ExperimentsArchive
EDUCATION
JoVE CoreJoVE BusinessJoVE Science EducationJoVE Lab ManualFaculty Resource CenterFaculty Site
Terms & Conditions of Use
Privacy Policy
Policies

Related Experiment Videos

Optimal investigation policies under selected PSRO procedures

D A Dittman, R P Magee

    Medical Care
    |October 1, 1980
    PubMed
    Summary

    This study introduces a new model for healthcare utilization review, helping Professional Standards Review Organizations (PSROs) optimize concurrent stay certification timing. The goal is to maximize benefits from utilization review costs for better patient care management.

    Related Concept Videos

    You might also read

    Related Articles

    Articles linked to this work by shared authors, journal, and citation graph.

    Sort by
    Same author

    Determination of the minimum dose of lactose drug carrier that can be sensed during inhalation.

    British journal of clinical pharmacology·1995
    Same author

    Measuring efficiency in acute care hospitals: an application of data envelopment analysis.

    Journal of health and human resources administration·1992
    Same author

    Hospital profit planning under Medicare reimbursement.

    Operations research·1984
    Same author

    A comparison of alternative medicare reimbursement policies under optimal hospital pricing.

    Health services research·1983
    Same author

    Optimal pricing of hospital services.

    Inquiry : a journal of medical care organization, provision and financing·1981
    Same author

    Consideration of benefits and costs: a conceptual framework for the health planner.

    Health care management review·1980

    Area of Science:

    • Health Services Research
    • Operations Research
    • Healthcare Management

    Background:

    • Healthcare utilization review is crucial for managing costs and quality.
    • Professional Standards Review Organizations (PSROs) face challenges in optimizing review timing.
    • Current methods may not efficiently balance review costs with benefits.

    Purpose of the Study:

    • To present a novel methodology for utilization review process optimization.
    • To aid PSROs in selecting the optimal timing for concurrent stay certification by diagnosis.
    • To provide a cost-benefit framework for determining the most effective utilization review strategy.

    Main Methods:

    • Modeling patient admissions, inpatient stays, and discharges as a stochastic process.
    • Integrating preadmission, concurrent, and retrospective review techniques.

    Related Experiment Videos

  • Determining concurrent stay certification timing to maximize benefits relative to review costs.

    • Main Results:

    • The methodology offers a tool for PSRO management to identify cost-beneficial utilization review processes.
    • The model is generalizable across different PSRO jurisdictions.
    • Computer programs supporting the methodology are readily available.

    Conclusions:

    • The proposed methodology provides valuable insights into modeling utilization review.
    • It offers a framework for PSROs to determine situation-specific, cost-effective utilization review procedures.
    • Further research is ongoing for parameter estimation to enhance model application.