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Article
October 5, 1984

The Ancillary Services Review Program in Massachusetts: Experience of the 1982 Pilot Project

Author Affiliations

From The Health Data Institute, Inc, Newton, Mass (Drs Hughes and Gertman and Mss Friedman and Ward); the Department of Medicine, Massachusetts General Hospital, Boston (Dr Hughes); the Health Care Research Section, Boston University School of Medicine (Drs Gertman, Anderson, and Kreger); and Blue Cross of Massachusetts, Inc, Boston (Ms Rosen).

JAMA. 1984;252(13):1727-1732. doi:10.1001/jama.1984.03350130041032
Abstract

In 1982, a pilot program to review the use of ancillary services in 25 hospitals was implemented in Massachusetts. The program analyzed hospital claims data to generate statistical models of ancillary use. Hospitals where the model demonstrated substantially higher use were subjected to clinical review. For laboratory services, three of the four hospitals reviewed were found to have more than 30% inappropriate use of selected tests, compared with approximately 20% in other hospitals. For cardiac services, three hospitals were each found to have more than 30% inappropriate use of selected tests, compared with 16% in other hospitals. When informed of these results, five of the six hospitals used them to develop plans of corrective action. Based on the pilot program, a review of ancillary services began in all Massachusetts hospitals in 1983.

(JAMA 1984;252:1727-1732)

References
1.
Iglehart JK:  The new era of prospective payment for hospitals .  N Engl J Med 1982; 20:1288-1292.Crossref
2.
Gertman PM, Monteir AC, Anderson JT, et al:  Utilization review in the United States: Results from a 1976-1977 national survey of hospitals .  Med Care 1979;17( (suppl) ):1-148.
3.
Showstack JA, Schroeder SA, Matsumato MF:  Changes in use of medical technologies, 1972-1977 .  N Engl J Med 1982;306:706-712.Crossref
4.
Griner PF, Glaser RJ:  Misuse of laboratory tests and diagnostic procedures .  N Engl J Med 1982;21:1336-1339.Crossref
5.
Eisenberg J:  The use of ancillary services: A role for utilization review?  Med Care 1982; 20:849-861.Crossref
6.
Eisenberg J:  An educational program to modify laboratory utilization of housestaff .  J Med Educ 1977;52:578-581.
7.
Zieve L:  Misinterpretation and abuse of laboratory tests by clinicians .  Ann NY Acad Sci 1966;134:563-572.Crossref
8.
Dickson RH, Lazio J:  Utilization of clinical chemistry services by medical house staff .  Arch Intern Med 1974;134:1064-1067.Crossref
9.
Daniels M, Schroeder SA:  Variation among physicians in use of laboratory tests .  Med Care 1977;15:482-487.Crossref
10.
Koran LM:  The reliability of clinical methods, data and judgements .  N Engl J Med 1975; 293:642-646, 695-701.Crossref
11.
Gertman PM, Restuccia JD:  The appropriateness evaluation protocol: A technique for assessing unnecessary days of hospital care .  Med Care 1981;19:855-871.Crossref
12.
Commission on Professional and Hospital Activities:  Length of Stay in PAS Hospitals by Diagnosis, Northeast Region, 1980 . Ann Arbor, Mich, Commission on Professional and Hospital Activities, 1981.
13.
Myers LP, Schroeder SA:  Physician use of services for the hospitalized patient: A review, with implications for cost containment .  Milbank Mem Fund Q 1981;59:481-507.Crossref
14.
Eisenberg JM, Williams SV:  Cost containment and changing physicians' practice behavior: Can the fox learn to guard the chicken coop?  JAMA 1981;246:2195-2201.Crossref
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