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International Journal for Quality in Health Care 7:201-212 (1995)
© 1995 International Society for Quality in Health Care

Design and Development of a Utilization Review Program in Portugal

MARGARIDA BENTES, MARIA DA LUZ GONSALVES, MARGARIDA SANTOS and ELAINE PINA

Departmento de Desenvolvimento de Sistemas de Financiamento e de Gestao, Intituto de Gestqao Informatica e Financeira da Saude Lisbon, Portugal

This paper describes the work that has been under way in the Portuguese government hospital sector, with respect to the use of an adapted version of the Appropriateness Evaluation Protocol (AEP). Modifications to the original system were determined through a series of experiments at pilot hospitals and reliability and user profile studies were subsequently conducted using the modified criteria.

Results were of great value in terms of the identification and quantification of problems. On average, approximately one in every four non-obstetric admissions and one in every 2 days of stay were deemed inappropriate and 75% of all inappropriate days were related to patients who were ready for discharge.

It is expected that the use of the modified AEP will be extended and enhanced over the next few years. In this regard, advantage has already been taken of the implementation of an output-based funding system, combining retrospective statistical analysis of the hospitals' inpatient databases with targeted reviews of individual patients.

Keywords: AEP, PRU, utilization review, inappropriate hospital use

Correspondence: Dr M. Bentes, IGIF, Ministéro da Saúde, Av. da Republica 61–20, Lisbon 1050, Portugal.

Received for publication April 3, 1995. Accepted for publication June 13, 1995.


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