Utilization Review

Monitoring programmes in the USA that seek to determine the appropriateness of the care delivered and its cost. Reviews, which may be retrospective, current or prospective, usually evaluate the need, appropriateness and efficiency of health care services, procedures and facilities, including review of the appropriateness of admissions, services ordered and provided, length of stay and discharge practices. Utilization reviews in the USA are performed both by peer review groups and by public agencies.

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