Controlling workers' compensation medical care use and costs through utilization management

Journal of Occupational and Environmental Medicine

Volumn 41, Issue 8, 1999, Pages 625-631

  Wickizer, Thomas M ^a   Lessler, Daniel ^b   Franklin, Gary ^a,c  

^a UNIVERSITY OF WASHINGTON   (United States)

^b UNIVERSITY OF WASHINGTON   (United States)

^c WASHINGTON STATE DEPARTMENT OF LABOR AND INDUSTRIES   (United States)

Author keywords

[No Author keywords available]

Indexed keywords

AMBULATORY SURGERY; ARTICLE; COST CONTROL; HEALTH CARE COST; HEALTH CARE QUALITY; HEALTH CARE UTILIZATION; HOSPITAL ADMISSION; HOSPITAL CARE; LENGTH OF STAY; MANAGED CARE; OUTPATIENT CARE; WORKMAN COMPENSATION;

ADULT; AGED; AMBULATORY CARE; CHILD; COST CONTROL; COST SAVINGS; FEMALE; HEALTH SERVICES MISUSE; HUMANS; INSURANCE CLAIM REVIEW; LENGTH OF STAY; MALE; MANAGED CARE PROGRAMS; MIDDLE AGED; PATIENT ADMISSION; QUALITY ASSURANCE, HEALTH CARE; UNITED STATES; UTILIZATION REVIEW; WORKERS' COMPENSATION;

EID: 0032816383     PISSN: 10762752     EISSN: None     Source Type: Journal    
DOI: 10.1097/00043764-199908000-00003     Document Type: Article

References (22)

1. Payne SM. Identifying and managing inappropriate hospital utilization: a policy synthesis. Health Serv Res. 1987;22: 709-769.
2. Restucia JD, Gertman P. A comparative analysis of appropriateness of hospital care. Health Aff. 1984;3:130-138.
3. Gold MR, Hurley R, Lake T, Ensor T, Berenson R. A national survey of the arrangements managed-care plans make with physicians. W Engl J Med. 1995; 333:1678-1683.
4. Sullivan CB, Miller M, Feldman R, Dowd B. Employer-sponsored health isurance in 1991. Health Aff. 1992;11: 172-185.
5. Wickizer TM. The effect of utilization review on hospital use and expenditures: a review of the literature and an update on recent findings. Med Care Rev. 1990; 47:327-363.
6. Jarvis KB, Phillips RB, Danielson C. Managed care preapproval and its effect on the cost of Utah worker compensation claims. J Manipulative Physiol Ther. 1997;6:372-376.
7. Restucia JD, Kreger BE, Payne SM, Gertman P, Dayno SJ, Lenhart GM. Factors affecting appropriateness of hospital care in Massachusetts. Health Care Financ Rev. 1986;8:47-56.
8. Siu AL, Sonnenberg A, Manning WG, et al. Inappropriate use of hospitals in a randomized trial of health insurance plans. N Engl J Med. 1986;315:1259-1266.
9. Wennberg J Gittelsohn A. Variations in medical care among small areas. Sci Am. 1982;246:120-134.
10. Chassin MR, Brook RH, Park RE, et al. Variations in the use of medical and surgical services in the Medicare population. N Engl J Med. 1986;314:285-290.
11. Wickizer TM, Wheeler JR, Feldstein PJ. Does utilization review reduce unnecessary care and contain costs? Med Care. 1989;27:632-646.
12. Feldstein PJ, Wickizer TM, Wheeler JR. Private cost containment: the effects of utilization review programs on health care use and expenditures. W Engl J Med. 1988;318:1310-1315.
13. Wickizer TM. The effects of utilization review on hospital use and expenditures: a covariance analysis. Health Serv Res. 1992;27:103-121.
14. Khandker RM, Manning WG, Ahmed T. Utilization review savings at the micro level. Med Care. 1992;30:1043-1052.
15. Scheffler RM, Sullivan SD, Ko TH. The impact of Blue Cross and Blue Shield plan utilization management. Inquiry. 1991;28:263-275.
16. Bailit HL, Sennett C. Utilization management as a cost-containment strategy. Health Care Financ Rev. 1991;annual suppl:87-91.
17. Wickizer TM. Controlling outpatient medical equipment costs through utilization management. Med Care. 1995;33: 383-391.
18. Wickizer TM, Lessler D, Travis KM. Controlling inpatient psychiatric utilization through managed care. Am J Psychiatry. 1996;153:339-345.
19. Wickizer TM, Lessler D. Do treatment restrictions imposed by utilization management increase the likelihood of read-mission for psychiatric patients? Med Care. 1998;36:844-850.
20. Wickizer TM, Lessler D. Effects of utilization management on patterns of hospital care among privately insured adult patients. Med Care. 1998;36:1545-1554.
21. Lessler D, Wickizer TM. The impact of utilization management on hospital read-missions for patients with cardiovascular disease. Health Serv Res. In press.
22. Wickizer TM, Lessler D. Effects of cost containment programs on patterns of care and readmissions among privately insured children and adolescents. Am J Public Health. In press.