What does Utilization Review primarily analyze?

Utilization Review primarily analyzes procedural appropriateness and resource consumption, focusing on ensuring that the healthcare services provided to patients are necessary and align with established standards. This function is essential in healthcare settings, as it evaluates whether the treatments and services offered are both appropriate for the patient's conditions and make efficient use of resources.

By scrutinizing the necessity of procedures and the allocation of resources, Utilization Review helps to maintain quality of care, reduce unnecessary expenditures, and optimize health outcomes for patients. It ensures that patients receive the right care at the right time while balancing cost and quality, thus playing a crucial role in overall healthcare management and quality improvement. This makes it an essential component of effective healthcare systems, where appropriate use of resources can also lead to improved patient experiences and outcomes.