This Article Full Text (PDF) References Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Alert me to new issues of the journal Add to Saved Citations Download to citation manager Request Permissions Request Reprints Add to My Marked Citations Citing Articles Citing Articles via Google Scholar Citing Articles via Scopus Google Scholar Articles by Grable, H. R. Search for Related Content PubMed Articles by Grable, H. R. Social Bookmarking                         What's this?

The Effect of Precertification on the Rate of Hospitalization of Patients with Low Back Pain

A Case Study Comparing Hospitalization Rates of Patients Covered by Workers' Compensation and No-Fault Automobile Insurance in New York State

This report is a study of the rates of hospitalization of two similar groups of patients with a diagnosis of medical low back pain resulting from an injury. It is based on a 7-year experience with utilization review. None of the patients had met the minimal criteria for hospitalization described by the "Reference Criteria for Short-Stay Hospital Review" of the American Medical Association (1). One of these two groups was required to undergo a preservice review (precertifi cation) before hospitalization. The other group did not undergo this precertification. This study tests the hypotheses that there is a significant incidence of unnecessary hospitalization of patients with medical low back pain and that precertification does reduce this rate of hospitalization. It also tests the hypothesis that race, age, and gender correlate with this unnec essary hospitalization. Further, it examines the rela tionship between the precertification process and the time of admission and the length of stay once admit ted. The methods used are defined, and the contro versy surrounding precertification and unnecessary hospitalization in general, and for low back pain in particular, is described.

American Journal of Medical Quality, Vol. 4, No. 4, 101-107 (1989)
DOI: 10.1177/0885713x8900400403


CiteULike    Complore    Connotea    Del.icio.us    Digg    Reddit    Technorati    Twitter    What's this?