From the patient s perspective, outcomes can be based on both the functional and perceptual benefits resulting from the health car intervention. Physician Profiling compares physicians on selected criteria and may be used for educational purposes to share information with physicians in a non-adversarial manner to encourage interest and participation in designing positive alternatives for change. Variations may be attributable to the fact that some patients are really sicker than others. Severity of illness can be adjusted by applying any of several severity adjustment software packages currently on the market. The second source of variation is the physician.
Physician behavior is a key issue when looking at variations in patient care.
Also known as preadmission certification, preadmission review and precert. Often involves appropriateness review against criteria and assignment of length of stay. Failure to obtain precertification often results in a financial penalty to either the provider or subscriber. A method of reviewing possible hospitalization, prior to admission, to determine necessity of confinement, outpatient alternatives and estimated length of stay. A formal set of activities to assure the quality of services provided.