Statistically developed criteria used for utilization review screening.
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Retrospective UR may be the method of choice if, in general, a problem is best addressed through a sampling of completed records. Note that this type of review is currently different from a patient care evaluation or audit. Such studies usually compare optimum standards of care for a diagnosis with the actual care delivered to patients as documented in their records. Retrospective UR, however, may be used to focus on a problem in the delivery of care that has previously been identified. As such, it can be an effective component of a total quality assurance program.
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