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• W97136492 abstract "Back to table of contents Previous article Next article Full AccessValidity of utilization management criteria for psychiatryPublished Online:1 Apr 2006https://doi.org/10.1176/ajp.154.3.349AboutSectionsView articleAbstractPDF/EPUB ToolsAdd to favoritesDownload CitationsTrack Citations ShareShare onFacebookTwitterLinked InEmail View articleAbstractOBJECTIVE: This study examined the validity of four psychiatric utilization management criteria sets: the 1992 and 1993 InterQual Intensity, Severity, and Discharge (ISD) criteria, the Managed Care Appropriateness Protocol, and an instrument developed by the Department of Veterans Affairs (VA). METHOD: The appropriateness of acute care admission and continued stay for 70 randomly selected VA psychiatric inpatients was retrospectively assessed with each criteria set. The sensitivity and specificity of each instrument were evaluated by comparing its assessments to the consensus of judgments of a panel of expert psychiatrists who reviewed the same cases. Sensitivity was defined as the proportion of admissions or continued-stay days the panel found appropriate for acute care that the criteria judged to be appropriate for acute care; specificity was the proportion the panel found inappropriate for acute care that the criteria judged to be inappropriate for acute care. RESULTS: For admissions, there were only minor differences in the validity of the four criteria sets as assessed by agreement with the panel's judgments. For each of 4 continued-stay days studied, either the sensitivity or specificity of the 1993 InterQual ISD criteria was below 0.30. The specificity of the 1992 InterQual ISD criteria was below 0.60 for 2 days. In contrast, for the Managed Care Appropriateness Protocol, sensitivity was 0.73-0.93 and specificity was 0.78-0.88 over the 4 days. CONCLUSIONS: The findings raise major concerns about the validity of the widely used InterQual ISD psychiatry criteria, suggest that the Managed Care Appropriateness Protocol may be a useful tool for psychiatric utilization management, strongly underline the need to validate all criteria used to assess medical care, and support the appropriateness of the procedures used to perform these assessments. FiguresReferencesCited byDetailsCited ByCreating Value: Resource and Quality Management18 October 2022The Accuracy of Interqual Criteria in Determining the Observation versus Inpatient Status in Older Adults with SyncopeThe Journal of Emergency Medicine, Vol. 59, No. 2The Accuracy of Interqual Criteria in Determining the Need for Observation Versus Hospitalization in Emergency Department Patients With Chronic Heart FailureCritical Pathways in Cardiology: A Journal of Evidence-Based Medicine, Vol. 12, No. 4Best Practices: Level-of-Care Decision Making in Behavioral Health Services: The LOCUS and the CALOCUSWesley Sowers, M.D., Andres Pumariega, M.D., Charles Huffine, M.D., and Theodore Fallon, M.D., M.P.H.1 November 2003 | Psychiatric Services, Vol. 54, No. 11Utilization Management: Issues, Effects, and Future ProspectsAnnual Review of Public Health, Vol. 23, No. 1Journal of the American Geriatrics Society, Vol. 48, No. 2Interaction of Fluoxetine and Valproic AcidM. Isabel Lucena, M.D., P.H.D., Encarnación Blanco, M.D., Miguel A. Corrales, M.D., and Marcelo L. Berthier, M.D., 1 April 1998 | American Journal of Psychiatry, Vol. 155, No. 4Utilization Management Criteria for PsychiatryPaul M. Steen, M.D., 1 April 1998 | American Journal of Psychiatry, Vol. 155, No. 4 Volume 154Issue 3 March 1997Pages 349-354 Metrics PDF download History Published online 1 April 2006 Published in print 1 March 1997" @default.
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