Identifying physicians and patterns generating unnecessary in-hospital days. An exploratory stage of developing an institution-specific physician-focused utilization effort.

A focused, concurrent utilization review effort identified the existence of a large number of unnecessary hospital days remaining even after a highly successful utilization review effort. Within a group of physicians identified as having the highest acuteness adjusted average lengths of stay, 38.3% of their patient's hospital days were unnecessary, with 83% of those days being within physician control. Observation, diagnostic undertakings or therapeutic efforts that were unnecessary or appropriate for the outpatient setting represented 81.3% of the unnecessary days. A future utilization study will compare the practice patterns among physicians in the same department in order to define future goals and develop necessary corrective actions that will be acceptable to the medical staff.