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Operational audit can help ensure long-term cost containment.

Any health care institution can use operational auditing, or operational review, to regularly evaluate the performance of specific units or of the entire institution, to identify conditions that need the most improvement, and, thereby, to select the best cost containment and revenue-enhancing approaches. This article discusses certain features and advantages of operational auditing, such as its use of industry and other substantive standards and the auditors' independence from the institution's internal politics. It also explains some important differences between operational auditing and internal auditing and the details of the operational auditing process.

Cost Control↗

A comprehensive package of support to facilitate the treatment of problem drug users in primary care: an evaluation of the training component.

Since the early 1980s, government policy documents and specialist reports have encouraged the involvement of general practitioners (GPs) in the treatment of problem drug users. In spite of such policy initiatives, their involvement has been patchy and slow. In response to this apparent reluctance, the London Boroughs of Brent and Harrow established the substance misuse management project (SMP) to support and train GPs in the management of substance misuse. The SMP is a GP-led project that provides ongoing support, shared-care protocol, primary care team training, treatment audits and financial reimbursements. In 1996, the SMP worked with GPs who were not currently involved in treating problem drug users, and those who were providing only minimal interventions. This paper evaluates the training and support given to these GPs and examines changes in their practice. A pre- and post-test survey was undertaken of GP knowledge, attitudes and levels of activity. A structured questionnaire was administered to all GPs before training (n=40) and re-administered between 6 and 9 months following training. SMP audit data were also reviewed to validate any reported changes in practice. All GPs initially reported insufficient knowledge to manage problem drug users. One-fifth were unaware they could prescribe methadone, and nearly half believed drug problems should be treated by specialist services. Post-training, the GPs had increased their levels of treatment activity and reported greater confidence and willingness to treat. This study demonstrates the potential to involve GPs in the treatment of problem drug users. The training was part of a package that included ongoing support sessions, team training, audits of treatment and financial reimbursements. It is proposed that, whilst training is a necessary condition, a more comprehensive package of support is needed to facilitate the treatment of problem drug users in primary care.

Journal Article↗

Periodic reviews improve pension fund management.

An independent review and audit of pension fund management can help a plan sponsor improve the fund's financial performance. Reviewing a pension fund's management periodically is important to determine if, among other things, the fund's investment policy is reasonable; the fees charged by investment managers, pension consultants, and trustees are acceptable; and certain revenue-generating ideas (i.e., securities lending and soft dollar usage) are being properly implemented/employed.

Financial Audit↗