utilization

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utilization

Use Managed care The use or amount of usage per unit population, of health care services; the pattern of use of a service or type of service in a specified time, usually expressed in rate per unit of population-at-risk for a given period–eg, number of hospital admissions/yr/1,000 persons enrolled in an HMO. See Hospital utilization, Overutilization, Underutilization.

utilization

(ūt″ĭl-ĭ-zā′shŏn) [L. utilis, usable]
In health care, the consumption of services or supplies, such as the number of office visits a person makes per year with a health care provider, the number of prescription drugs taken, or the number of days a person is hospitalized.

utilization,

n 1. the extent to which a given group uses a particular service in a specified period. Although usually expressed as the number of services used per year per 100 or per 1000 persons eligible for the service, utilization rates may be expressed in other ratios.
2. the extent to which the members of a covered group use a program over a stated time, specifically measured as a percentage determined by dividing the number of covered individuals who submitted one or more claims by the total number of covered individuals.
utilization management,
n a set of techniques used by or on behalf of purchasers of health care benefits to manage the cost of health care before its provision by influencing patient-care decision making through case-by-case assessments of the appropriateness of care based on accepted dental practices.
utilization review (UR),
n 1. analysis of the necessity, appropriateness, and efficiency of medical and dental services, procedures, facilities, and practitioners. In a hospital, this includes review of the appropriateness of admissions, services ordered and provided, and length of stay and discharge practices, on concurrent and retrospective bases.
2. a statistically based system that examines the distribution of treatment procedures based on claims information and, to be reasonably reliable, the application of such claims. Analyses of specific dental professionals should include data on type of practice, dental professionals' experience, socioeconomic characteristics, and geographic location.