Control over the Utilization of Medical Services

Abstract

The authors consider the issues and problems involved in the control of medical utilization. Five categories of control are considered: supply limitations, financial disincentives, authorization requirements, review mechanisms, and legal actions. The success or failure of these mechanisms hinges upon whose use is being regulated, who performs the control activities, whether the attempted control involves a judgment of the appropriateness of treatment, and whether the attempt to control occurs before, after, or during treatment.