Booth B M, Ludke R L, Wakefield D S, Kern D C, du Mond C E
VA Medical Center, Iowa City.
Hosp Health Serv Adm. 1991 Fall;36(3):421-37.
A critical issue for utilization management programs is how much of the hospitalization should be reviewed and whether information relative to the admission provides information about the subsequent days of stay. This study evaluates the relationship between the appropriateness (defined as overutilization of acute, inpatient services) of admissions and all days of stay in a probability sample of 6,063 hospitalizations from 50 Department of Veterans Affairs medical centers (VAMCs). Results suggest that preadmission reviews in hospital-based utilization management programs may eliminate not only unnecessary admissions but also, in most cases, completely inappropriate hospitalizations. In addition, except where inpatient-appropriate surgeries are not performed in a timely manner, review of the rest of the stay may not be an efficient use of time and resources.
利用管理计划的一个关键问题是应审查多少住院时间，以及与入院相关的信息是否能提供关于后续住院天数的信息。本研究评估了50个退伍军人事务部医疗中心（VAMC）的6063例住院病例的概率样本中，入院的适宜性（定义为急性住院服务的过度使用）与所有住院天数之间的关系。结果表明，基于医院的利用管理计划中的入院前审查不仅可以消除不必要的入院，而且在大多数情况下，还可以消除完全不适当的住院。此外，除非及时进行了适合住院患者的手术，否则对其余住院时间的审查可能不是对时间和资源的有效利用。
