Final answer:
Utilization management is used to determine whether a patient should be treated as an outpatient or as an inpatient. It involves assessing the appropriate level of care for a patient based on their medical condition, the required treatments, and the associated costs.
Step-by-step explanation:
Utilization management is used to determine whether a patient should be treated as an outpatient or as an inpatient. It involves assessing the appropriate level of care for a patient based on their medical condition, the required treatments, and the associated costs.
For example, if a patient requires a complex surgery that can only be performed in a hospital, they would typically be treated as an inpatient. On the other hand, if a patient needs routine medical check-ups and medication management, they can be treated as an outpatient.
Utilization management helps healthcare providers optimize resources and ensure that patients receive the most appropriate and cost-effective care.