Utilization Review in the Military Health Care Delivery System: A Case Study
Final rept. Jul 1990-Jul 1991
ACADEMY OF HEALTH SCIENCES (ARMY) FORT SAM HOUSTON TX HEALTH CARE STUDIES DIV
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In the case presented, a cost control mechanism is developed for a major Army medical center. Utilization Review UR, the predominant cost control mechanism used in the civilian health care industry is discussed, along with its implications for the military health care delivery system. Following an analysis of the situation at Madigan Army Medical Center, a UR program is processed. Components of existing civilian UR programs are extracted and used for aspects of UR that are common to both civilian hospitals and the Army medical center. New approaches, such as statistically computed Upper Expenditure Control Limits and Lower Expenditure Control Limits, and a modified form of focused retrospective UR are developed to meet the unique demands of the Army health care delivery system.... Utilization review, Cost control, Military health care, Utilization management, Continual quality improvement.
- Economics and Cost Analysis
- Medicine and Medical Research
- Medical Facilities, Equipment and Supplies