International Journal for Quality in Health Care 11:13-19 (1999)
© 1999 International Society for Quality in Health Care
An experience of utilization review in Europe: sequel to a BIOMED project
0 Gabinete del Plan de Calidad, Fundación Hospital Alcorcón-Madrid, Spain
1 Department of Public Health Medicine, United Medical and Dental Schools of Guy's and St Thomas Hospital, London, UK
2 Medical Informatics Unit, Paris Hospital, Paris, France
3 Institut Universitaire de Médecine Sociale et Préventive, Lausanne, Switzerland
Correspondence to: S Lorenzo, Gabinete del Plan de Caliad, Fundacion Hospital Alcorcon, Avda, Villaviciosa s/n, 28922 Alcorcón, Madrid, Spain
e-mail: slorenzo@fhalcorcon.es
Objective. To develop and test a utilization review screening tool for use in European hospitals.
Setting. In 1993 a group of researchers financed by a European Union grant reviewed the use of utilization review in Europe. They quickly noticed a lack of specifically designed instruments able to take into account the health care and cultural differences across Europe, and available for use in different health care systems. Hence, they embarked upon the task of developing and testing a utilization review screening tool for use in European hospitals.
Results. The European-Union-Appropriateness Evaluation Protocol's list of reasons was developed and assessed. This is a common taxonomy that classifies days identified as unnecessary and provides a list of levels of care to identify patients' needs. This new protocol not only substitutes for the multiple previous local versions of the Appropriateness Evaluation Protocol, but will also facilitate comparisons of the varying experiences in European countries.
Main findings. Development of utilization review in Europe has been carried out mostly on a voluntary basis and the main objective was not control. The experience varies widely: from France, where utilization review is still developing and research has been implemented by local teams, to Portugal, where utilization review programmes have been initiated by government authorities. At this point different initiatives in quality improvement, and more specifically in utilization review, are being developed within the European context.
Keywords: appropriateness evaluation protocol, appropriateness of hospital use, Europe, European appropriateness evaluation protocol, utilization review
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