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Utilization Review

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  • Topic: Utilization review
  • Program: Quality/Equality
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Most Health Care Organizations Address Patient Safety Only Indirectly

July 1, 2004 | Program Result

From 2002 to 2003, research staff at URAC studied utilization management companies to learn how they use utilization management technology and processes to identify and manage potential patient safety problems.

Utilization Management Can Negatively Impact Health Care Quality and Access

June 1, 1999 | Program Result

From 1992 to 1997, researchers at the University of Washington School of Public Health and Community Medicine evaluated the effects of utilization management on health care quality and access.

How Satisfied are Physicians and Patients When Medical Groups Control Access to Care?

April 1, 1997 | Program Result

The University of California, Los Angeles, School of Medicine examined how the structure and intensity of utilization management in physician groups with capitated contracts affect primary care physician and patient satisfaction.

Florida Develops Utilization Management System for Youth Mental Health Services

June 1, 2000 | Program Result

A 1996 legislative mandate directed Florida's Agency for Health Care Administration to develop a utilization management system for Medicaid-funded mental health and substance abuse services in order to achieve $34 million in savings.

How Will Comparative Effectiveness Research Affect the Quality of Health Care?

February 1, 2010 | Issue Brief

Paper explores the potential impact of comparative effectiveness research and looks at implications for quality of care and health outcomes.

Reducing Payment for Imaging in Referring Doctor's Facility Does Not Reduce Utilization

August 1, 1998 | Program Result

From 1994 to 1996, researcher teams at the University of Virginia and the Primary Care Outcomes Research Institute (PCORI) at the New England Medical Center conducted two distinct but parallel studies.

Access to Care Impacts Hospitalization Rates for Ambulatory Care Sensitive Conditions

April 1, 2001 | Program Result

The University of California studied access to primary care in selected communities to assess whether hospitalization rates for certain chronic conditions typically managed by outpatient care are valid and useful measures of community access to care.

Poor More Likely to be Hospitalized for Diseases Preventable with Primary Care

July 1, 2001 | Program Result

The United Hospital Fund of New York worked to develop, validate and implement a research technique called small-area analysis, used to identify communities with high rates of unnecessary hospitalization and limited access to primary care.

Variations Found During Physician Profiling Study Are Difficult to Explain

March 1, 2000 | Program Result

The Center for Research in Ambulatory Health Care Administration developed, tested and demonstrated a national physician profiling system for ambulatory health care.

How Managed Care Allocates Resources

March 1, 1998 | Program Result

The Hastings Center, a nonprofit bioethics research institute located in Garrison, N.Y., used applied research to examine the ethical questions involved with resource allocation by managed care organizations.

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