Intensive,Focused Utilization Management in a Teaching Hospital An Exploratory Study

Abstract

A 3-month study was performed in a teaching hos pital to determine the impact of intensive, focused utilization management on the average length of stay and average total charges in a carefully defined group of indigent patients. Prompt admission review was performed, the treatment plan ascertained, and a physician advisor notified. The attending physician was informed by a physician advisor of the patient's financial class, and assistance with expediting patient care and discharge planning was offered. Daily con current review monitored the treatment and dis charge plans. The study compared 73 patients with a control group of 191 patients of similar financial class and diagnosis related groups (DRGs) for the immedi ately preceding 3 months. Compared with the control patients, the study patients experienced a 23% de crease in average length of stay and 16% decrease in average total charges. This study indicates that an intensive utilization management effort in a teaching hospital can be effective without compromising the quality of care.

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