Definition of Utilization Review



Utilization review is the review of health care facilities being utilized by a citizen in respect of quality and efficiency. The utilization review officers administer whether the health care services are provided according to the protocols that are more suitable in a given situation.

 


For example, Alex had an accident and he was taken to the orthopedic ICU. The utilization review nurse will note the details of the injury, the treatment is provided and the quality of care being used. If the nature of the injury is not so serious the utilization review nurse can clarify with the doctors if the nature of care is necessary or it can be altered to treat it more economically.


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