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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 ...
In the context of an entire economy, resources can be allocated by various means, such as markets, or planning. In project management, resource allocation or resource management is the scheduling of activities and the resources required by those activities while taking into consideration both the resource availability and the project time. [1]
Shortage of beds can result in cancellations of admissions for planned (elective) surgery, admission to inappropriate wards (medical vs. surgical, male vs. female etc.), delay admitting emergency patients, [6] and transfers of existing inpatients between wards, which "will add a day to a patient's length of stay". [1]
The generic model used in the United States is the chronic care model, which holds that health care does not only involve change in the patient and that high-quality disease care counts the community, the health system, self-management support, delivery system design, decision support, and clinical information systems as important elements in ...
Health systems management ensures that specific outcomes are attained, that departments within a health facility are running smoothly, that the right people are in the right jobs, that people know what is expected of them, that resources are used efficiently and that all departments are working towards a common goal.
These include discussions on functional vs. cross-functional resource allocation as well as processes espoused by organizations like the Project Management Institute (PMI) through their Project Management Body of Knowledge (PMBOK) methodology of project management. Resource management is a key element to activity resource estimating and project ...
There are criticisms of QALY. One involves QALY's lack of usefulness to the healthcare provider in determining the applicability of alternative treatments in the individual patient environment, [3] and the absence of incorporating the patient's willingness to pay (i.e. behavioral economics) in decisions to finance new treatments. [4]
Collection of sufficient resources from the economy in an appropriate manner along with allocating and use of these resources efficiently and effectively constitute good financial management. Resource generation, resource allocation, and expenditure management (resource utilization) are the essential components of a public financial management ...