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Criteria and Flowsheet for Utilization Review by Level of Care.

HRP0019122

Publication Date	1977
Personal Author	Goldberg, G. A.; Hein, L. M.; Rosales, S. M.; Alexander, J. F.
Page Count	6
Abstract	Level-of-care criteria for use in the conduct of utilization review in hospitals and clinics at the University of California at Los Angeles are presented, and a flow chart of the utilization review process by level of care is included. The concept of level of care is considered to be a reasonable basis for deciding whether a patient should be located in an acute care hospital. Level of care is defined as the type, number, and/or intensity of a combination of physician, skilled nursing, and ancillary services. Explicit level-of-care criteria are listed that deal with physician services, skilled nursing services, medical services available only in an acute care hospital, rehabilitation services, and psychiatric services. The advantages of using level-of-care criteria as opposed to disease-specific criteria are enumerated. A short list of references is included. Two figures illustrate the principles presented -- the flowchart of the review process and a one-page summary of the level-of-care guidelines used by a utilization reviewer and representing services only available in an acute care hospital environment.
Keywords	State regions Standards Reviewing Rehabilitation Quality assurance Patients Nursing Methodology Medical services Measurement Inpatient services Health occupations Health care Health care services Health care delivery Evaluation California Assessments Reprints Utilization review Level of care HRP/DEAA HRP/ZL HRP/DCA HRP/EBA HRP/KE HRP/KXAA HRP/KABA HRP/KGA HRP/KF HRPGEO/YCA HRPGEO/YCN HRPOCC/X Criteria Flow charts Hospitals Outpatient clinics
Source Agency	Bureau of Health Planning and Resources Development Health Research Administration
NTIS Subject Category	44D - Health Care Assessment & Quality Assurance
Corporate Authors	California Univ., Los Angeles. School of Medicine.; National Center for Health Services Research, Rockville, MD.
Document Type	Journal Article
NTIS Issue Number	197809

Criteria and Flowsheet for Utilization Review by Level of Care.

Criteria and Flowsheet for Utilization Review by Level of Care.
HRP0019122

Publication Date	1977
Personal Author	Goldberg, G. A.; Hein, L. M.; Rosales, S. M.; Alexander, J. F.
Page Count	6
Abstract	Level-of-care criteria for use in the conduct of utilization review in hospitals and clinics at the University of California at Los Angeles are presented, and a flow chart of the utilization review process by level of care is included. The concept of level of care is considered to be a reasonable basis for deciding whether a patient should be located in an acute care hospital. Level of care is defined as the type, number, and/or intensity of a combination of physician, skilled nursing, and ancillary services. Explicit level-of-care criteria are listed that deal with physician services, skilled nursing services, medical services available only in an acute care hospital, rehabilitation services, and psychiatric services. The advantages of using level-of-care criteria as opposed to disease-specific criteria are enumerated. A short list of references is included. Two figures illustrate the principles presented -- the flowchart of the review process and a one-page summary of the level-of-care guidelines used by a utilization reviewer and representing services only available in an acute care hospital environment.
Keywords	State regions Standards Reviewing Rehabilitation Quality assurance Patients Nursing Methodology Medical services Measurement Inpatient services Health occupations Health care Health care services Health care delivery Evaluation California Assessments Reprints Utilization review Level of care HRP/DEAA HRP/ZL HRP/DCA HRP/EBA HRP/KE HRP/KXAA HRP/KABA HRP/KGA HRP/KF HRPGEO/YCA HRPGEO/YCN HRPOCC/X Criteria Flow charts Hospitals Outpatient clinics
Source Agency	Bureau of Health Planning and Resources Development Health Research Administration
NTIS Subject Category	44D - Health Care Assessment & Quality Assurance
Corporate Authors	California Univ., Los Angeles. School of Medicine.; National Center for Health Services Research, Rockville, MD.
Document Type	Journal Article
NTIS Issue Number	197809