Health Care EconomicsFull Access

Utilization Review Questions

Published Online:2 Jul 2004https://doi.org/10.1176/pn.39.13.0390010a

To examine the relationship between utilization management techniques and psychiatrists' treatment plans, the following questions were among those posed to 615 psychiatrists in the American Psychiatric Institute for Research and Education's Practice Research Network. Results are discussed in the story above.

Are your treatment recommendations for this patient subject to any of the following utilization management or quality assurance techniques?

	1.	Utilization review (precertification, concurrent review, administrative, or utilization case management).
	2.	Incentives or requirements to use specific practice guidelines or treatment algorithms.
	3.	Restrictions on or specification of the medications that can be prescribed.
	4.	Financial incentives or penalties to limit referrals.
	5.	Referrals limited to selected hospital or specialist panels.

Have financial considerations (managed care limitations, patient's resources, or limitations of a public system) resulted in any of the following for this patient?

	1.	Reducing the frequency of visits you would optimally like to provide.
	2.	Reducing the number of visits you would optimally like to provide.
	3.	Providing a different form of treatment than you would optimally like to provide.
	4.	Selecting or switching to a different medication than you would prefer.

ISSUES

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Utilization Review Questions

ISSUES