医院利用审查对选定诊断领域医疗支出的影响：一项探索性研究。
Effect of hospital utilization review on medical expenditures in selected diagnostic areas: an exploratory study.
作者信息
Wickizer T M
机构信息
Department of Health Services, University of Washington, Seattle 98195.
出版信息
Am J Public Health. 1991 Apr;81(4):482-4. doi: 10.2105/ajph.81.4.482.
Abstract
Quarterly claims data on 43 insured groups were analyzed through multivariate techniques to explore whether the effects of hospital inpatient utilization review vary across selected broad diagnostic areas. Findings suggest that utilization review was associated with decreases in expenditures of approximately 15 percent for diagnoses within the surgical area, a lesser decrease within the mental health area, and still lesser decrease within the medical area. However, these measurements are imprecise both because of the small numbers and the aggregated diagnoses in each category.
摘要
通过多变量技术对43个参保群体的季度理赔数据进行了分析，以探讨医院住院利用情况审查的效果在选定的广泛诊断领域是否存在差异。研究结果表明，利用情况审查与外科领域诊断的支出减少约15%相关，在心理健康领域减少幅度较小，在医疗领域减少幅度更小。然而，由于每个类别中的数量较少且诊断汇总，这些测量并不精确。
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