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Utilization management is "a set of techniques used by or on behalf of purchasers of health care benefits to manage health care costs by influencing patient care decision-making through case-by-case assessments of the appropriateness of care prior to its provision," as defined by the Institute of Medicine [1] Committee on Utilization Management by Third Parties (1989; IOM is now the National ...
Between 2013 and 2017, healthcare providers created 11 new integrated delivery systems from joint ventures with insurance companies. [6] Some insurance companies have invested in primary care, particularly UnitedHealthcare, which runs a provider subsidiary, OptumCare. [7]
Health information technology (HIT) is "the application of information processing involving both computer hardware and software that deals with the storage, retrieval, sharing, and use of health care information, health data, and knowledge for communication and decision making". [8]
Collaboration between health care technology companies and providers can free up doctors and nurses to spend more time with patients. ... Demand is surging as a result of aging populations and a ...
The Andersen healthcare utilization model is a conceptual model aimed at demonstrating the factors that lead to the use of health services. According to the model, the usage of health services (including inpatient care, physician visits, dental care etc.) is determined by three dynamics: predisposing factors, enabling factors, and need.
In addition, they may apply the science of informatics to the collection, storage, analysis, use, and transmission of information to meet legal, professional, ethical and administrative records-keeping requirements of health care delivery. [1] They work with clinical, epidemiological, demographic, financial, reference, and coded healthcare data.
To provide access to healthcare services, especially in underserved areas and geographically distant regions. [8] [9] To facilitate access to people with disabilities and mobility limitations. [10] To facilitate access to health and educational tools to informal caregivers. [11] To reduce healthcare costs and increase distribution to population ...
Process denotes the transactions between patients and providers throughout the delivery of healthcare. Finally, outcomes refer to the effects of healthcare on the health status of patients and populations. [2] Avedis Donabedian, a physician and health services researcher at the University of Michigan, developed the original model in 1966. [3]