News and Commentary

Are we undermanaging hospital care?


When it comes to unnecessary treatment, hospitalization is still a fat cow despite shorter inpatient stays forced by managed care, a Milliman & Robertson study suggests. Using physician consultants, the actuarial company conducted random inpatient chart reviews to determine which services were medically necessary. From that, M&R derived the appropriateness of an admission, as well as unnecessary services and inpatient days. Its conclusion that more than half of unmanaged inpatient days are unnecessary has implications for the relative need for inpatient and outpatient facilities, staffing and costs.

SOURCE: ANALYSIS OF MEDICALLY UNNECESSARY INPATIENT SERVICES, MILLIMAN & ROBERTSON INC., MILWAUKEE, 1997

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