Utilization Review and Analysis of Nonurgent PRIMUS Referrals to the Darnall ArmyCommunity Hospital Internal Medicine Clinic

摘要

A utilization review and analysis was conducted for referrals from PRIMUS clinicsto the Internal Medicine Clinic at Darnall Hospital from 1 April to 30 September 1993. Actual costs for 206 referrals to both Darnall Hospital and CHAMPUS were calculated. The study found that Darnall Hospital provided needed referral services in a more cost effective manner than standard CHAMPUS. However, partnership physicians provided needed medical care at a substantially lower cost to Darnall Hospital with no copayment to the patient. The study reported that Internal Medicine Clinic physicians spend a relatively small portion of their reported working time in the outpatient clinic. Conversely, nurse practitioners report a higher number of working hours and significantly higher levels of productivity than their physician counterparts. Recommendations include reducing appointment length, improving the no-show fill rate, changing duty locations for Internal Medicine Clinic physicians so that they treat more patients in the outpatient clinic.