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.
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