Utilization Review in the Military Health Care Delivery System: A Case Study

Abstract

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.

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Document Details

Document Type
Technical Report
Publication Date
May 17, 1991
Accession Number
ADA261619

Entities

People

  • David H. Pratt Jr.

Organizations

  • Academy of Health Sciences

Tags

DTIC Thesaurus Topics

  • Business Administration
  • Families (Human)
  • Health Care
  • Health Services
  • Hospitals
  • Medical Personnel
  • Military Hospitals
  • Military Medicine
  • Organizational Structure
  • Patient Care
  • Therapy

Fields of Study

  • Medicine

Readers

  • Medical or Health Care Field.
  • Systems Analysis and Design