Tan J K, McCormick E, Sheps S B
Department of Health Care and Epidemiology, University of British Columbia, Vancouver, Canada.
Hosp Health Serv Adm. 1993 Spring;38(1):81-99.
This article introduces the concept of a utilization care plan (UCP) for supporting the communication of data required for effective utilization review and utilization management. Utilization review is a process of measurement that compares the performance of a ward, department, or entire facility against accepted criteria to identify resource use shortfalls. Utilization management is the deliberate action by third party payers to ensure that shortfalls in resource utilization are minimized. Critical to the success of utilization management is effective data communication; utilization review data must be accurate, complete, accessible, timely, and coordinated. Computer-based UCP systems can remind caregivers when and what services should be provided to patients and also monitor the portion of those services that should be administered during each phase of a patient's therapy. Deviations from the UCP system template constitute variances that can be documented and highlighted in a friendly automated system that ensures highly accurate and extremely timely concurrent utilization information. Some implications of using UCP systems for future research and practice are also discussed.
本文介绍了利用护理计划（UCP）的概念，以支持有效利用审查和利用管理所需数据的交流。利用审查是一个衡量过程，将病房、科室或整个机构的绩效与公认标准进行比较，以识别资源使用不足情况。利用管理是第三方支付方采取的有意行动，以确保资源利用不足情况降至最低。有效数据交流对利用管理的成功至关重要；利用审查数据必须准确、完整、可获取、及时且协调一致。基于计算机的UCP系统可以提醒护理人员何时以及应为患者提供何种服务，还可以监测患者治疗各阶段应提供的那些服务的比例。与UCP系统模板的偏差构成差异，这些差异可以在一个友好的自动化系统中记录并突出显示，该系统可确保提供高度准确且极其及时的并发利用信息。使用UCP系统对未来研究和实践的一些影响也进行了探讨。
