What does the term 'utilization review' primarily focus on?

Prepare for the HCQM Quality Improvement, Management, and Assurance Test. Utilize flashcards and multiple choice questions, each with hints and explanations for effective study. Excel in your exam!

Utilization review primarily focuses on the evaluation of the necessity of healthcare services. This process is designed to ensure that patients receive appropriate care based on their clinical needs and that the services provided are both necessary and effective. By systematically assessing the appropriateness of healthcare services, utilization review helps to prevent unnecessary procedures and tests, thus promoting more efficient use of healthcare resources.

In practice, utilization review involves examining various aspects of patient care, such as the appropriateness of admissions, the duration of hospital stays, and the types of treatments administered. The ultimate goal is to enhance the quality of care, ensure that it aligns with evidence-based guidelines, and improve overall healthcare outcomes while managing costs effectively.

The other choices are important in their own contexts but do not encompass the primary focus of utilization review. Patient feedback and satisfaction pertain more to the experience of care rather than its necessity. Tracking healthcare expenditures relates to financial management rather than the evaluation of service necessity. Employee performance evaluations focus on the competencies and effectiveness of staff, which is separate from the assessment of healthcare services provided to patients.

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