What Is Utilization In Health Care

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Utilization Management 101: Why it's Important in Healthcare

(3 days ago) WEBWhat is Utilization Management in Healthcare? In healthcare, utilization management is the techniques and policies for evaluating the necessity of medical treatments and services on a case-to-case basis. The typical utilization management …

https://www.edenhealth.com/blog/what-is-utilization-management/

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A Description of Theoretical Models for Health Service Utilization: …

(3 days ago) WEBThe delivery of healthcare contributes toward individual, community, and population level health outcomes. 3 Therefore, research efforts to understand the health service utilization process are important to equitably deliver high-quality health services to all individuals, communities, and populations. To guide health services research, …

https://journals.sagepub.com/doi/full/10.1177/00469580231176855

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Health Care Utilization SpringerLink

(4 days ago) WEBHealth Care Utilization is the quantification or description of the use of services by persons for the purpose of preventing and curing health problems, promoting maintenance of health and well-being, or obtaining information about one’s health status and …

https://link.springer.com/referenceworkentry/10.1007/978-1-4419-1005-9_885

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Utilization Management in Healthcare Smartsheet

(7 days ago) WEBUtilization management (UM) is a process that evaluates the efficiency, appropriateness, and medical necessity of the treatments, services, procedures, and facilities provided to patients on a case-by …

https://www.smartsheet.com/content/utilization-management

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Health-Care Utilization as a Proxy in Disability Determination.

(5 days ago) WEBHealth-care utilization is determined by the need for care, by whether people know that they need care, by whether they want to obtain care, and by whether care can be accessed. Quality is a construct separate from access and is related to the achievement of favorable outcomes associated with utilization, not to whether health …

https://www.ncbi.nlm.nih.gov/books/NBK500097/

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Health Care Utilization - an overview ScienceDirect Topics

(1 days ago) WEBHealth-care utilization is primarily determined by the need for service (i.e., levels of illness and disability), the availability of services, and the resources available for providing and paying for service. In countries with fewer freely available services, economic status plays a larger role in determining health-care utilization.

https://www.sciencedirect.com/topics/nursing-and-health-professions/health-care-utilization

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Utilization Management - StatPearls - NCBI Bookshelf

(5 days ago) WEBUtilization Management (UM), initially referred to as Utilization Review (UR), remains a well-recognized component of a cost management approach in the health care service delivery and payment …

https://www.ncbi.nlm.nih.gov/books/NBK560806/

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Controlling Costs and Changing Patient Care? The Role of …

(5 days ago) WEBHowever, widespread application of this approach to managing health care utilization is a phenomenon of the 1980s. A survey conducted in 1983 reported that only 14 percent of corporate benefit plans required prior approval of nonemergency admissions to hospitals (Equitable Life Assurance Society of the United States, 1983). By 1988, another

https://www.ncbi.nlm.nih.gov/books/NBK234995/

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Healthcare Utilization SpringerLink

(6 days ago) WEBHealthcare utilization includes complex and multifaceted behaviors with many influences beyond those related to health and illness. Sociodemographic characteristics, culture, economics, personality, perceptions, access to services, attitudes and beliefs, and social roles are just a few examples from a long list of nonhealth factors …

https://link.springer.com/referenceworkentry/10.1007/978-3-319-69892-2_991-1

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Utilization Management: Issues, Effects, and Future Prospects

(Just Now) WEBAbstract Utilization management encompasses a diverse set of activities designed to influence the use of health care services and thereby constrain health care resource consumption. Utilization management, which has become one of the most widely used cost-containment approaches, has engendered debate and controversy. Physicians …

https://www.annualreviews.org/content/journals/10.1146/annurev.publhealth.23.100901.140529

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How Utilization Review Works - Verywell Health

(1 days ago) WEBUtilization review is the process of making sure healthcare services are being used appropriately and efficiently, which is a key component of a value-based approach to paying for health care . This …

https://www.verywellhealth.com/utilization-review-what-it-is-how-it-works-1738788

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How has healthcare utilization changed since the pandemic?

(1 days ago) WEBIn 2021, healthcare prices increased by 2.9%, in line with previous years, but health services use increased by 7.3% relative to 2020. This increase in healthcare use in 2021 followed a sharp decrease in health utilization in 2020, largely driven by the COVID-19 pandemic, as many health services, such as elective procedures and routine …

https://www.healthsystemtracker.org/chart-collection/how-has-healthcare-utilization-changed-since-the-pandemic/

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Utilization Management, Case Management, and Care …

(1 days ago) WEBUtilization management (UM) is the mix of clinical, administrative, and financial methods used to evaluate the appropriateness, processes, facilities, and providers of care applied to an individual and a total population of patients. Case management (CM) is a centralization of the planning, arranging, and follow-up of a member’s specific …

https://link.springer.com/chapter/10.1007/978-3-030-48080-6_7

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What Is Utilization Management In Healthcare? - enter.health

(4 days ago) WEBUtilization management is an important component of healthcare operations, as it helps to ensure that patients receive high-quality and appropriate care. The goal of utilization management is to analyze the effectiveness of treatments for each patient before, during, and after care delivery. Strong utilization management program helps

https://www.enter.health/post/what-is-utilization-management-in-healthcare

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Healthcare Cost and Utilization Project (HCUP)

(1 days ago) WEBThe Healthcare Cost and Utilization Project (HCUP, pronounced "H-Cup") is a family of databases, software tools and related products developed through a Federal-State-Industry partnership and sponsored by AHRQ. HCUP databases are derived from administrative data and contain encounter-level, clinical and nonclinical information including all

https://www.ahrq.gov/data/hcup/index.html

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Utilization Management as a Cost-Containment Strategy

(8 days ago) WEBUtilization management (UM) is now an integral part of most public and private health plans. Hospital review, until recently the primary focus of UM, is associated with a reduction in bed days and rate of hospital cost increases. These reductions appear to have had limited impact on aggregate health care costs because of

https://www.cms.gov/Research-Statistics-Data-and-Systems/Research/HealthCareFinancingReview/Downloads/CMS1191182dl.pdf

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Health Care Utilization Following Interventions to Improve Social …

(8 days ago) WEBHealth care utilization refers to using primary care (visits to the general practitioner or nurse), emergency care (visits to the emergency department), inpatient care (eg, number of hospitalizations and readmissions, length of stay), and outpatient care (visits to a specialist, such as a cardiologist, obstetrician, or psychiatrist) services

https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2806587

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National Center for Health Statistics - Centers for Disease …

(9 days ago) WEBHealth care utilization can be appropriate or inappropriate, of high or low quality, expensive or inexpensive. The study of trends in health care utilization provides important information on these phenomena and may spotlight areas that may warrant future indepth studies because of potential disparities in access to, or quality of, care.

https://www.cdc.gov/nchs/data/misc/healthcare.pdf

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Common Utilization Measures That Impact Value-Based Care Efforts

(9 days ago) WEBUtilization measures such as emergency department use, hospital readmissions, and preventive care use are crucial to improving quality of care. Source: Getty Images. July 20, 2023 - Quality and

https://healthpayerintelligence.com/features/common-utilization-measures-that-impact-value-based-care-efforts

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Higher Healthcare Utilization, Intensity Drive Healthcare Spending

(3 days ago) WEBOctober 29, 2021 - Increased utilization and intensity of healthcare services are the top driving factors of healthcare spending growth, a report from the American Hospital Association (AHA) revealed.. The COVID-19 pandemic has exacerbated these circumstances, as hospitals face staff shortages and increased patient demand. …

https://revcycleintelligence.com/news/higher-healthcare-utilization-intensity-drive-healthcare-spending

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Early 2021 data show no rebound in health care utilization

(1 days ago) WEBEarly in the COVID-19 pandemic, stay-at-home measures, potential risk of COVID infection at a hospital or doctors’ offices, and concerns over hospital capacity led to sharp declines in health care utilization and spending, including drops in hospital admissions for both acute and elective procedures. There was also a drop in preventive …

https://www.healthsystemtracker.org/brief/early-2021-data-show-no-rebound-in-health-care-utilization/

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Health Care Utilization CDC

(1 days ago) WEBHigher health care use among adults with IBD Compared with adults without IBD, those with IBD are more likely to use health care including doctors’ visits, medication prescriptions, emergency department visits, hospitalizations, and surgeries. Urban-rural differences in health care utilization related to IBD

https://www.cdc.gov/ibd/data-and-statistics/healthcare-utilization.html

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Cost, Quality, and Utilization After Hospital-Physician and Hospital

(1 days ago) WEBThis systematic review synthesizes recent evidence examining the association between two types of vertical integration-hospital-physician (n = 43 studies) and hospital-post-acute care (PAC; n = 10 studies)-and cost, quality, and health services utilization. Hospital-physician integration is associated with higher health care costs, but the

https://pubmed.ncbi.nlm.nih.gov/38708895/

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METHODS FOR ANALYZING HEALTH CARE UTILIZATION AND …

(2 days ago) WEBAbstract Important questions about health care are often addressed by studying health care utilization. Utilization data have several characteristics that make them a challenge to analyze. In this paper we discuss sources of information, the statistical properties of utilization data, common analytic methods including the two-part model, and some …

https://www.annualreviews.org/content/journals/10.1146/annurev.publhealth.20.1.125

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Health-Care Utilizations - Health-Care Utilization as a Proxy in

(5 days ago) WEBEmergency Medical Services. Emergency medical services (EMS)—most commonly thought of as ambulance service but also including aeromedical and other prehospital services—constitutes another health-care utilization and plays a critical role in the health-care system by providing timely out-of-hospital emergency medical care …

https://www.ncbi.nlm.nih.gov/books/NBK500105/

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As AI Utilization Advances in Health Care, Experts at ATS 2024 …

(2 days ago) WEBAs AI Utilization Advances in Health Care, Experts at ATS 2024 Share Insights. Fatima Rodriguez, MD, MPH, from Stanford University, and Matthew DeCamp, MD, PhD, from the University of Colorado

https://www.ajmc.com/view/as-ai-utilization-advances-in-health-care-experts-at-ats-2024-share-insights

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High Telehealth Use Tied to Increased Health Care Utilization, Cost

(3 days ago) WEBBy Lori Solomon HealthDay Reporter. TUESDAY, May 14, 2024 -- Higher telehealth use in a hospital service area is tied to increased health care utilization and cost, according to a study published online May 13 in JAMA Network Open. Morteza Saharkhiz, Ph.D., from Meta Platforms Inc. in Menlo Park, California, and colleagues …

https://www.drugs.com/news/telehealth-tied-increased-health-care-utilization-cost-119228.html

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Misdiagnosing Bipolar I as MDD Increases Health Care Utilization, …

(5 days ago) WEBThe results of this study suggest the prompt and accurate diagnosis of BD has the potential to significantly reduce healthcare utilization and costs. The total health care costs in the previous 12

https://www.psychiatryadvisor.com/news/misdiagnosing-bipolar-mdd-increases-health-care-utilization-costs/

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Health Insurance Costs Are Squeezing Workers and Employers

(Just Now) WEBHealth care has been one of the fastest-growing segments of the economy, 69 rising from $2.6 trillion in 2010 to $4.1 trillion in 2020­—at which point it represented nearly 20 percent of U.S

https://www.americanprogress.org/article/health-insurance-costs-are-squeezing-workers-and-employers/

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[PDF] Healthcare Utilization, Physical and - Semantic Scholar

(4 days ago) WEBThe evidence-based information serves as a reference for medical staff to reduce the occurrence of self-injurious behavior in patients with asthma. Background Patients with asthma experience more physical, psychological, and financial burdens; a link between asthma and suicidality has been reported in research. Purpose This study …

https://www.semanticscholar.org/paper/Healthcare-Utilization%2C-Physical-and-Psychiatric-in-Huang-Chiou/93c019774aa36b62f6eb0bb9a83bcfd37e62973b

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Patients seen by female gastroenterologists have less health care

(1 days ago) WEB"The next step is to take a closer look at the patient data—including preexisting conditions, the health care utilization patterns prior to an initial GI consultation, and the diagnoses that

https://medicalxpress.com/news/2024-05-patients-female-gastroenterologists-health-male.html

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Examining the Period-Based Changes in the Effect of …

(6 days ago) WEBABSTRACT. Applying dependency theory, this manuscript uses data from the six cross-sectional Tanzania Demographic Health Surveys from 1991 to 2016 (n = 30,028) to explore temporal variations in the effect of socioeconomic status (SES) on maternal healthcare (MHC) utilization across different residences and regions.Research in this …

https://www.tandfonline.com/doi/full/10.1080/00380237.2024.2354450

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Self-Reported Frailty and Health Care Utilization in Community …

(4 days ago) WEBSelf-Reported Frailty and Health Care Utilization in Community-Dwelling Middle-Aged and Older Adults in the United States. Frailty, a dynamic state, is a consequence of cumulative deficits in multiple physiological systems accompanied by an increased vulnerability to stressor events. 1 The aging of the population has increased the prevalence of

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10173381/

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Evoke Pharma to Present Additional GIMOTI Healthcare Utilization …

(6 days ago) WEBEvoke Pharma, Inc. announced that its abstract demonstrating enhanced gastroparesis care in women using nasal metoclopramide will be presented at the 2024 Digestive Disease Week Conference taking place May 18-21, 2024 in Washington D.C. Evoke Pharma to Present Additional GIMOTI Healthcare Utilization Data Focused on …

https://www.biospace.com/article/releases/evoke-pharma-to-present-additional-gimoti-healthcare-utilization-data-focused-on-gastroparesis-care-insights-in-women-at-2024-digestive-disease-week-ddw-conference/

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