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  2. Utilization management - Wikipedia

    en.wikipedia.org/wiki/Utilization_management

    Prospective review is typically used as a method of reducing medically unnecessary admissions or procedures by denying cases that do not meet criteria, or allocating them to more appropriate care settings before the act. Concurrent review is carried out during and as part of the clinical workflow, and supports point of care decisions.

  3. Drug utilization review - Wikipedia

    en.wikipedia.org/wiki/Drug_Utilization_Review

    Prospective drug utilization review refers to assessing appropriate drug and decision making therapeutically before patients' medication are dispensed. [10] This prospective review is based on the history recording of the drug and medication. Then, practitioners could assess therapy for patients on the basis history recording. [11]

  4. Clinical peer review - Wikipedia

    en.wikipedia.org/wiki/Clinical_peer_review

    Clinical peer review, also known as medical peer review is the process by which health care professionals, including those in nursing and pharmacy, evaluate each other's clinical performance. [ 1 ] [ 2 ] A discipline-specific process may be referenced accordingly (e.g., physician peer review , nursing peer review ).

  5. SSAE No. 18 - Wikipedia

    en.wikipedia.org/wiki/SSAE_No._18

    AT-C section 305, effective May 1, 2017, sourced from SSAE No. 18, contains requirements and guidance for examining or performing agreed-upon procedures on prospective financial information. [ 28 ] [ 5 ]

  6. Scholarly peer review - Wikipedia

    en.wikipedia.org/wiki/Scholarly_peer_review

    Extended peer review is the process of including people and groups with experience beyond that of working academics in the processes of assuring the quality of research. If conducted systematically, this can lead to more reliable, or applicable, results than a peer review process conducted purely by academics. [125]

  7. Preferred Reporting Items for Systematic Reviews and Meta ...

    en.wikipedia.org/wiki/Preferred_reporting_items...

    The PRISMA flow diagram, depicting the flow of information through the different phases of a systematic review. PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) is an evidence-based minimum set of items aimed at helping scientific authors to report a wide array of systematic reviews and meta-analyses, primarily used to assess the benefits and harms of a health care ...

  8. Systematic review - Wikipedia

    en.wikipedia.org/wiki/Systematic_review

    A systematic review is a scholarly synthesis of the evidence on a clearly presented topic using critical methods to identify, define and assess research on the topic. [1] A systematic review extracts and interprets data from published studies on the topic (in the scientific literature), then analyzes, describes, critically appraises and summarizes interpretations into a refined evidence-based ...

  9. Diagnosis-related group - Wikipedia

    en.wikipedia.org/wiki/Diagnosis-related_group

    The history, design, and classification rules of the DRG system, as well as its application to patient discharge data and updating procedures, are presented in the CMS DRG Definitions Manual (Also known as the Medicare DRG Definitions Manual and the Grouper Manual). A new version generally appears every October. The 20.0 version appeared in 2002.