Emphasizing "Level of Care" over "Length of Stay" in Hospital Utilization Review

Bibliographic Data

ID14338204
AuthorsGeorge A Goldberg (corresponding author), Dox C Holloway (corresponding author)
Year1975
Volume13
Issue6
Pages474-485
Publication date1975-06-01
Open AccessNo
TypeARTICLE
VenueMedical Care (JOURNAL)
Journal identifiersISSN: 0025-7079 • E-ISSN: 1537-1948
PublisherOvid Technologies (Wolters Kluwer Health) (PUBLISHER)
DOI10.1097/00005650-197506000-00004
PMID1095840
OpenAlexW1988374885
LanguageEN
Citations received2
References cited1

Utilization review has heretofore emphasized "length of stay" as the criterion for deciding when the patient is ready to leave the hospital. We suggest that "level of care" (the type, number, and/or intensity of a combination of physician, skilled nursing, and ancillary services) received by the patient should replace length of stay as the major "decision" criterion for deciding on continued hospitalization: "appropriate hospital placement" means the patient is currently receiving a level of care available only in the hospital. Length of stay should be the criterion for signaling intervals when patients are (re) reviewed to determine the currently needed level of care. Explicit criteria for determining when a patient is receiving a hospital level of care should be developed. Explicit criteria will increase objectivity, provide guidance to utilization review coordinators, and assist the hospital in defending its utilization review decisions to an intermediary or Professional Standards Review Organization (PSRO). Level of care will be reflected in a patient's "service profile," a listing of all the services being received by the patient on any given day of hospitalization. The services profile varies throughout hospitalization; hospitalization is appropriate when a patient's current services profile constitutes a level of care available only in the hospital

MEDLINE · Political science · Medicine · Pharmacy and Medical Practices

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