Optimal investigation policies under selected PSRO procedures.
This article presents a methodology for utilization review which aids the local Professional Standards Review Organization (PSRO) in selecting optimal timing of Concurrent Stay certification by diagnosis. This procedure is accomplished by modeling patients' admissions, inpatients stays and discharge...
| Publicado en: | Medical Care Vol. 18; no. 10; pp. 1032 - 1048 |
|---|---|
| Autores principales: | , , , |
| Formato: | equations & formulas tables/charts Journal Article |
| Publicado: |
Lippincott Williams & Wilkins
Oct1980
|
| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=113847778&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 113847778 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 00257079 21B jtl: Medical Care issn: 00257079 maglogo: N pubinfo: dt: Oct1980 vid: 18 iid: 10 pid: 433 pub: Lippincott Williams & Wilkins place: Baltimore, Maryland artinfo: ui: 113847778 113847778 NLM7192785 113847778 NLM7192785 113847778 ppf: 1032 ppct: 16 formats: tig: atl: Optimal investigation policies under selected PSRO procedures. aug: au: Dittman, David A. Magee, Robert P. Dittman, D A Magee, R P affil: ∗Associate Professor, Graduate School of Business Administration, Duke University †Professor, Graduate School of Management, Northwestern University sug: subj: Utilization Review Methods Peer Review Organizations Utilization Review Models, Theoretical Statistics ab: This article presents a methodology for utilization review which aids the local Professional Standards Review Organization (PSRO) in selecting optimal timing of Concurrent Stay certification by diagnosis. This procedure is accomplished by modeling patients' admissions, inpatients stays and discharges for each diagnosis as a stochastic process which is audited under the PSRO by three utilization review techniques: preadmission, concurrent and retrospective review. The timing of concurrent stay certification is determined so that the maximum benefits are derived for the utilization review cost expanded. The methodology presented here is a tool to aid local PSRO management in determining the most cost-beneficial utilization review process to utilized in their jurisdiction. It is not an attempt to demonstrate the effectiveness of our utilization review policy over another in general. On the contrary, while the model is generalizable to every PSRO, the utilization review policies resulting from any application are situation-specific. The major contributions of this article are new insight into modeling the utilization review process and the provision of a methodology for which computer programs exist and are readily available to any PSRO that should desire to determine its utilization review procedure in this cost-benefit framework. In order to apply the model it is necessary that certain parameters specific to the application site be estimated or assumed. Exact procedures to aid the PSRO in parameter estimation is the subject of current investigation. pubtype: Academic Journal doctype: equations & formulas tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
|---|