A Statistical Control Model for Utilization Management Programs
A Statistical Control Model for Utilization Management Programs
复制标题
利用管理计划的统计控制模型
DOI：
10.1080/10920277.1998.10595707
复制
发表时间：
1998
期刊：
影响因子：
--
通讯作者：
M. Rosenberg
中科院分区：
文献类型：
--
作者：
M. Rosenberg
摘要提出了一种新的方法来监测医疗保健成本，以帮助控制成本的努力。这篇内容丰富的文章旨在提供有关改善卫生保健管理过程的方法的信息并激发讨论。保险公司和提供者收集的数据可用于分析和改善医疗保健过程。新的统计技术，以及更好、更一致的数据输入，将是成功的利用管理计划的关键。新方法成功的必要条件是：（1）诊断协议是“真正的黄金标准”，（2）令人满意的疾病分类系统，（3）有意义的和一致的编码数据，（4）尽可能多地利用可用数据的统计方法。住院过程中示出了一个廉价的统计控制过程，以减少不必要的住院的发生率。
Abstract A new approach is proposed for monitoring health-care costs to help in cost containment efforts. This informative essay is intended to provide information on and stimulate discussion of ways of improving the health-care management process. Data that are being collected by insurers and providers could be used to analyze and improve the health-care process. New statistical techniques, and better, more consistent input of data, will be critical to successful utilization management programs. Necessary conditions for the success of the new methods are (1) diagnosis protocols that are “true gold standards,” (2) a satisfactory disease classification system, (3) meaningful and consistently coded data, and (4) statistical methodology that takes advantage of as much of the available data as possible. The hospital admissions process is illustrated to show the incorporation of an inexpensive statistical control process for reducing the incidence of unnecessary hospitalizations.