Relation between quality assessment and utilization review in a functioning PSRO.
The Utah State Medical Association, through its peer-review foundation, the Utah Professional Review Organization, has implemented an integrated system of utilization reveiw and quality assessment linked to a program of continuing education.  Nurse co-ordinators, employed by the Organization, screen all hospitalized patients covered by Titles XVIII, XIX and V as well as by subscribing private insurers. Approximately 10 per cent of hospitalized patients do not meet peer-generated criteria for admission review or length of stay and are screened out for peer review,  The nurse co-ordinators collect data for retrospective quality assessment, identifying targets for continuing medical education.  Preliminary data support the cost effectiveness of such a review program.  Continuing qualtiy audit will test the effectiveness of education programs.
D004502:Education, Medical, Continuing; D006760:Hospitalization; D007902:Length of Stay; D008484:Medicaid; D008485:Medical Audit; D006278:Medicare; D009726:Nurses / Q000706:statistics & numerical data; D010380:Peer Review; D011366:Professional Review Organizations; D011787:Quality of Health Care; D012955:Societies, Medical; D014589:Utah; D014600:Utilization Review