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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 ...
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.
An acceptable use policy (AUP) (also acceptable usage policy or fair use policy (FUP)) is a set of rules applied by the owner, creator, possessor or administrator of a computer network, website, or service that restricts the ways in which the network, website or system may be used and sets guidelines as to how it should be used.
Health policy and management or health systems management or health care systems management describes the leadership and general management of hospitals, hospital networks, and/or health care systems. In international use, the term refers to management at all levels. In the United States, management of a single institution (e.g. a hospital) is ...
Increasing or decreasing one results in changes to one or both of the other two. For example, a policy that increases access to health services would lower quality of health care and/or increase cost. The desired state of the triangle, high access and quality with low cost represents value in a health care system. [3]
"Abuse and violence against our healthcare workers is unacceptable," writes A.J. Wilhemi, CEO of the Illinois Health and Hospital Association.
Clinical governance is a systematic approach to maintaining and improving the quality of patient care within the National Health Service (NHS) and private sector health care. Clinical governance became important in health care after the Bristol heart scandal in 1995, during which an anaesthetist, Dr Stephen Bolsin , exposed the high mortality ...
Image source: The Motley Fool. CVS Health (NYSE: CVS) Q3 2024 Earnings Call Nov 06, 2024, 8:00 a.m. ET. Contents: Prepared Remarks. Questions and Answers. Call ...