This Article Full Text (PDF) References Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed 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 HighWire Citing Articles via Google Scholar Citing Articles via Scopus Google Scholar Articles by Booth, B. M. Articles by Fisher, E. M. Search for Related Content PubMed PubMed Citation Articles by Booth, B. M. Articles by Fisher, E. M. Social Bookmarking                         What's this?

Reliability of a Utilization Review Instrument in a Large Field Study

Iowa HSR&D Field Program, Veterans Affairs Medical Center, Iowa City, Iowa

Robert L. Ludke, Ph.D.

Iowa HSR&D Field Program, Veterans Affairs Medical Center, Iowa City, Iowa

Eileen M. Fisher, M.S.

Iowa HSR&D Field Program, Veterans Affairs Medical Center, Iowa City, Iowa

One important question for a utilization manage ment program is whether the utilization review in strument is consistent or stable when used on many occasions by the same abstractor (intrarater reliabil ity) or by several abstractors (inter-rater reliability). As part of a nationwide study of inappropriate utili zation of inpatient services by the Department of Veterans Affairs, we conducted a thorough investi gation of the inter-rater reliability of a widely used utilization review instrument by 27 nurse abstrac tors. All abstractors were extensively trained, both by the developers of the instrument and by use of practice medical records. A standard protocol for re solving questions was implemented, with immediate communication of decisions to abstractors. The re sults of three reliability assessments, conducted im mediately after formal training, after several weeks of reviewing practice records, and midway through review of the study records, demonstrated good to excellent reliability, both when comparing the nurse abstractors with a physician gold standard and among themselves. Therefore, with appropriate training and monitoring, utilization management programs in large hospitals, multihospital systems, and other health care organizations needing to examine inpa tient utilization should feel confident that they can achieve reviews that would be in close agreement with physician and other nurse abstractors. Such con fidence should increase the acceptability of utilization management programs.

American Journal of Medical Quality, Vol. 9, No. 2, 68-73 (1994)
DOI: 10.1177/0885713X9400900205


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

This article has been cited by other articles:

				V. Soria-Aledo, A. Carrillo-Alcaraz, A. Campillo-Soto, B. Flores-Pastor, J. Leal-Llopis, M. P. Fernandez-Martin, M. Carrasco-Prats, and J. L. Aguayo-Albasini Associated Factors and Cost of Inappropriate Hospital Admissions and Stays in a Second-Level Hospital American Journal of Medical Quality, July 1, 2009; 24(4): 321 - 332. [Abstract] [PDF]

				B. M. Booth, R. L. Ludke, and E. M. Fisher Inappropriate Hospital Care and of Illness: Results from a Nationwide Study American Journal of Medical Quality, March 1, 1998; 13(1): 36 - 43. [Abstract] [PDF]

				P. A. Glassman, J. H. Lopes, and T. Witt Using Proprietary Methods to Evaluate Acute Care Admissions to a Veterans Affairs Tertiary Care Center: Are the Appropriateness Criteria Appropriate? American Journal of Medical Quality, January 1, 1997; 12(3): 165 - 168. [Abstract] [PDF]