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American Journal of Medical Quality
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Reviews

Efficiency Gains in Utilization Review

Nitin Paranjpe

Michigan Health Care Education & Research Foundation, Detroit, Michigan 48226 and Blue Cross and Blue Shield of Michigan

Ira Strumwasser

Michigan Health Care Education & Research Foundation, Detroit, Michigan 48226 and Blue Cross and Blue Shield of Michigan

David L. Ronis

Michigan Health Care Education & Research Foundation, Detroit, Michigan 48226 and Blue Cross and Blue Shield of Michigan

Charlotte Bartzack

Michigan Health Care Education & Research Foundation, Detroit, Michigan 48226 and Blue Cross and Blue Shield of Michigan

Charles Zech

Michigan Health Care Education & Research Foundation, Detroit, Michigan 48226 and Blue Cross and Blue Shield of Michigan

A study was conducted to determine which Major Diagnostic Categories (MDCs) accounted for most of the nonessential hospital admissions in 73 Michigan hospitals in 1986. The Intensity, Severity, Discharge- Appropriateness (ISD-A) criteria set was used to identify nonessential admissions. Large concentra tions of nonessential admissions were found in medi cal, psychiatric, and substance abuse cases; surgical admissions had low rates of nonessential hospitaliza tion. Focusing utilization review on MDCs with non essential rates exceeding 15% results in an examina tion of 44% of admissions, while capturing 77% of nonessential admissions and 73% of potential dollar savings. Implications for UR activities are discussed.

American Journal of Medical Quality, Vol. 4, No. 4, 108-114 (1989)
DOI: 10.1177/0885713x8900400404
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