What is the purpose of a Utilization Review Committee?

• A. To administer health insurance
• B. To monitor for appropriate diagnosis and treatment
• C. To provide nursing care
• D. To conduct preventive health programs

Answer: (B)

The purpose of a Utilization Review Committee centers around the assessment and evaluation of healthcare services to ensure that patients receive appropriate diagnoses and treatments based on established medical criteria and standards. This committee plays a crucial role in reviewing the necessity and efficiency of healthcare provided to patients, which in turn helps in managing healthcare costs and maintaining quality of care.

By monitoring the appropriateness of diagnoses and treatments, the committee can identify any areas of overutilization or underutilization of services, thereby contributing to improved patient outcomes and ensuring that resources are utilized effectively. This focus on appropriateness distinguishes the committee's role from other functions in the healthcare system, such as administering health insurance or providing nursing care, which do not directly evaluate treatment decisions.