Which of the following best describes why utilization review ...

[Cooldude101]

Which of the following best describes why utilization review departments are becoming case management units?
 
  a. Funding is available for case management responsibilities.
  b. Monitoring service use alone does not improve patient outcomes.
  c. It facilitates using nurse experts for case management.
  d. It promotes the current trend of naming utilization review units case management.

Question 2

Which of the following conclusions can be drawn from reviewing how health care costs are spread over a person's lifetime?
 
  a. Health care expenditures increase with age.
  b. Premature newborns incur more costs than other children from birth through adulthood.
  c. The majority of cost is incurred during middle age when chronic diseases strike.
  d. Persons aged 85 years and above spend the most money on health care.

[abro1885]

Answer to Question 1

ANS: B
Case management programs evolved from utilization review departments when those departments demonstrated that monitoring service use alone is insufficient for managing patient populations with diverse resource needs. There is not readily available funding for case management responsibilities. Case management involves more than utilization review, so there is a changing role of the nurse associated with the change of the name of the department. Using nurse experts for case management is beneficial, but it is not the reason why these departments transitioned.

Answer to Question 2

ANS: A
Expenditures increase with age. About one third of costs are incurred during middle age; half during the senior years; and, for those older than 85 years, one third of their lifetime costs occurs during their last year of life.