Utilization review in healthcare primarily involves what activity?

Utilization review in healthcare is fundamentally focused on evaluating the appropriateness of healthcare services that patients receive. This involves assessing whether the care provided aligns with established guidelines, medical necessity, and the overall effectiveness of treatments in relation to expected outcomes. The review process is typically conducted by trained professionals, such as nurses or medical directors, who analyze patient records, treatment plans, and clinical protocols to ensure that the services are justified and that patients are receiving necessary and correct care.

This activity is crucial in managing healthcare quality and efficiency, as it aims to prevent unnecessary procedures or excessive use of resources while ensuring that patients receive essential and appropriate interventions. By focusing on appropriateness, utilization review ultimately helps in improving patient care standards and outcomes.

Other choices do not encompass the primary focus of utilization review: reducing costs may be an indirect effect or goal, but it's not the main activity; increasing hospital admissions contradicts the intent of ensuring only necessary services are provided; and improving staff training programs, while valuable, is not a component of utilization review itself.