The design and analysis of hospital utilization studies

The reports of hospital utilization review (UR) studies that appear in this issue employ a range of design strategies, and much of the variation seems accidental--arising because there are many acceptable strategies--rather than functional. This paper is about general design strategy: the value of explicit protocols for sampling and data collection, of analyses appropriate to the sampling, of generating reports managers can use. More coordination is strongly encouraged, to reduce unnecessary variation and to facilitate comparisons across studies. While individual groups may still opt for different strategies, techniques for increasing the comparability of reported findings are discussed. This will increase the value of each study, individually, as well as the value of the collective effort.