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Results for “Concurrent Review”

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At least 19 recordsLinked to original sources
PubMed1979

The relationship between diagnostic information available at admission and discharge for patients in one PSRO setting: implications for concurrent review.

Professional Standards Review Organization (PSRO) operating guidelines recommend the use of Professional Activity Study (PAS) length of stay norms for conducting concurrent review. These norms, determined by aggregating discharge abstracts from PAS hospitals in the same United States census region, are assigned to patients based only on information known at admission. This study investigated the relationship between patient information available at admission and the information available at discharge in light of its effects on the concurrent review process. Analyzing 52,210 patient records from 68 hospitals in one PSRO setting, it was found that changes in patients' primary diagnosis resulted in changes in their PAS diagnostic category for 41.3 per cent of the patients. A change in PAS diagnostic caetgory after the assignment of the review norm resulted in missed and unnecessary reviews as well as early and late reviews. These findings indicate that there are serious operational problems with the current method of performing concurrent review.

Commission on Professional and Hospital Activities↗
PubMed1995

Retrospective versus concurrent review on the quality of care of pediatric trauma patients.

To compare and contrast retrospective versus concurrent quality of care review processes in a Level I Trauma Center, we conducted a retrospective chart review of all pediatric trauma admissions in 1990 (n = 113) and compared it to the concurrent trauma quality assurance program for the same time period. Twenty-four percent (24%) of the patients reviewed in the retrospective study were identified by filters and reviewed through the concurrent process. In both the retrospective and concurrent review process problems in medical care problems, documentation, social and preventive elements of the case, and overall assessment of the patients' care were described. Overall, we found less than 50% agreement between the two reviews. The retrospective review identified medical care issues in 64% of cases, compared with a 44% error rate noted in the concurrent review (P < 0.07). Reviewers were more likely to note the absence of appropriate documentation, and overall assessment of the patients' care in the retrospective process (P < 0.0001). The retrospective review also highlighted issues related to the prevention of the injury and the patients' social situation, which were not considered by the concurrent review. Overall, we found the concurrent review appropriate for case by case medical management, while the retrospective review was relevant to a systems approach to the care of the injured child. To obtain a complete picture of the care of injured children, we recommend 1) a portion of charts be reviewed retrospectively in addition to ongoing concurrent review; or 2) the concurrent review add filters that are specific to pediatric issues and overall system issues.

Adolescent↗
PubMed1979

Reassessing the early effect of concurrent review on length of stay: Illinois, 1971--72.

The Hospital Admission and Surveillance Program (HASP) was a pre-PSRO program in Illinois. Established in February 1972, its objective was to reduce the cost of care given to Medicaid beneficiaries in that state. HASP approved length of stay (L.O.S.) on a prospective only basis, so that all Medicaid patients were reported promptly on admission. During 1972, the Illinois Medicaid program was rapidly expanding in patient volume, but not in scope of services. This study compares patients admitted to 46 hospitals in Illinois before and after the establishment of HASP. To adjust for changes in case mix between the two periods, each patient was matched for age, diagnosis and illness severity with patients in an appropriate comparison group. The complex process of matching raised the likelihood that changes in L.O.S. were caused by HASP's activities and not by other factors. L.O.S. fell significantly more for Medicaid than for non-Medicaid patients. In addition, the mix of diagnoses changed more markedly for Medicaid than non-Medicaid patients, emphasizing the need for case mix adjustments in this before-and-after study. Some findings suggest that the "post-HASP" admissions had the greater need for hospital care; this trend affected both Medicaid and non-Medicaid patients, however, The combined evidence suggests that concurrent review, as implemented by HASP, helped shorten L.O.S. in 1972. Whether quality of care changed was not studied.

Age Factors↗
PubMed1987

Concurrent review.

Explore the source record for details and available documents.

Concurrent Review↗
PubMed1996

Confessions of a concurrent reviewer.

The author describes his two years of experience as a physician reviewer for two managed care companies. With case examples, he illustrates how the training process and his early activities as a reviewer increased his awareness of the need for accountability in psychiatric practice. He describes several issues that he had to clarify before he felt comfortable in the reviewer's role. Among them were the need for psychiatrists to practice more crisis intervention; the difference between intensive treatment and 24-hour inpatient care; the need to find alternative solutions to situations in which patients are hospitalized for social or logistical reasons; the need for careful discharge planning; and the need to recognize and deal with the adversarial relationships that develop with colleagues whose cases are reviewed. The author offers a typology of the interactions that occur between physician reviewers and attending psychiatrists. He concludes that reviewing may have both salutary and detrimental effects on psychiatric practice.

Concurrent Review↗
PubMed1989

Concurrent review of the duration of antimicrobial prophylaxis in surgery.

The administration of prophylactic antibiotics in surgery is appropriate for many patients. Data have shown extending the duration of prophylaxis beyond 48 hours does not lower the rate of postoperative-infection. The purpose of this project was to concurrently assess the duration of prophylactic antibiotic use. A total of 95 patients were monitored over 3 weeks. Eighty patients (84.2%) received antimicrobial therapy. In 23 of these patients (28.75%) the duration of antibiotic administration was longer than 2 days without clinical or microbiological evidence of infection. In 5 other patients only postoperative antibiotics were prescribed. The cost difference between the actual duration of antibiotic administration and 2 days of the same regimen was +1,364.58. Extrapolating for one year, it can be estimated that antibiotic costs could be reduced about +23,600. Pharmacists can focus on the duration of antibiotic prophylaxis as a cost containment measure.

Adult↗
PubMed1986

Medical record professionals and the performance of concurrent review.

This month we feature two articles which discuss the performance of medical record review activities on the inpatient nursing unit by medical record professionals so that readers may profit by comparing and contrasting the viewpoints of the authors. This article highlights the appropriateness of having medical record professionals perform these activities.

Concurrent Review↗