Accession Number : ADA293420

Title :   Establishing an Effective Preadmission Certification Program in a Naval Medical Center.

Descriptive Note : Final rept. Jul 93-Jul 94,

Corporate Author : ACADEMY OF HEALTH SCIENCES (ARMY) FORT SAM HOUSTON TX HEALTH CARE ADMINISTRATI ON

Personal Author(s) : Hoffman, Paul M.

PDF Url : ADA293420

Report Date : MAY 1994

Pagination or Media Count : 69

Abstract : As resources for Department of Defense health care delivery diminish, the Naval Medical Center Portsmouth, Virginia must stretch funds while providing quality health care to eligible patrons. One cost containment mechanism is third party payer preadmission certification for patients requiring hospitalization. This case study found the process was fragmented due to inadequate education of clinical staff; physical and artificial barriers to effective communication and implementation, and conflicting department-specific operating procedures. The addition of a preadmission certification processor improved third party reimbursement and interdisciplinary communication, resulting in better patient care. Further research is required to determine the efficacy of the preadmission certification process as a utilization management tool. Alternatives like total case management should be considered to facilitate active collaboration of the delivery team members and encourage appropriate use of medical facilities and services, improve the quality of care and maintain cost-effectiveness on a case-by-case basis.

Descriptors :   *COSTS, *MILITARY MEDICINE, *HEALTH CARE FACILITIES, VIRGINIA, DELIVERY, DEFENSE SYSTEMS, MANAGEMENT, PHYSICAL PROPERTIES, HEALTH, NAVY, FACILITIES, TEAMS(PERSONNEL), CLINICAL MEDICINE, PROCESSING EQUIPMENT, CONTAINMENT(GENERAL), CASE STUDIES, QUALITY, BARRIERS, PATIENTS, MEDICAL SERVICES, UTILIZATION, MONEY.

Subject Categories : Medical Facilities, Equipment and Supplies
      Economics and Cost Analysis
      Medicine and Medical Research

Distribution Statement : APPROVED FOR PUBLIC RELEASE