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ABSTRACTAs part of the 1989 NHS Review, the government made participation in audit compulsory for the medical profession. Prior to this time, medical audit had been fragmented, implemented by "top‐down"initiatives promoted by professional bodies as well as by localized "bottom‐up"exercises undertaken by committed individuals. The paper uses evidence gained from four case studies of the implementation of medical audit in acute hospitals post 1989, to argue that during the early stages of policy implementation individualistic tendencies have, to some extent inadvertently, been given their head. This has not resulted in stronger external management of medical activities, as the government appeared initially to intend, but rather in locally determined medical audit activity, focused on technical process and medical management. However examining medical audit in the wider context of the total package of NHS reforms and of concurrent changes in medical management, suggests that medical interests, and the individualism that is characteristic of medical organization, will become diluted and less segregated in the future.

The application of audit to resource allocation and clinical practice has emerged as a fundamental principle in Western medical systems over recent years. Used effectively, audit can have wide-ranging benefits for both the patient and the practitioner, in terms of resource management and quality of care. To set up an efficient and productive audit facility requires careful planning and may encounter resistance. This book provides a detailed account of audit processes and discusses the application of audit in a variety of medical settings. It is both a thoughtful review and a practical guide to successful medical audit, the collection and utilization of information for effective resource management and improved patient care, in the hospital and in the community

The government, general managers, and professional bodies all agree that medical audit should be implemented throughout the United Kingdom. Nevertheless, it is not yet decided either nationally or locally how audit should be defined and what its implications will be. In an analysis to find ways of measuring the design and effectiveness of hospital audit, therefore, seven main measures emerged that might serve as practical criteria. These were the definition of medical and managerial responsibilities; medical organisation; scope of audit; essential characteristics; resources needed; record keeping; and evaluation. Though generally consistent with the proposals of the government and the Department of Health, these seven principles offer some alternative approaches.

Introduction: The delay in the processing of sick leaves (SLs) is a public health problema in Chile, considering that this affects the payment of the subsidy to the individuals destined to perform the prescribed medical rest while unable to work. The aim of this study was to explore the differences in the processing time of electronic SLs (ESLs) evaluated by medical audit (MA) and the SLs evaluated by a predictive medical audit system (PMAS) based on artificial neural networks. Materials and methods: The processing time of the ESLs that were processed by PMAS was compared with the processing time of those that were examined only by MA, using Kaplan Meier curves, log-rank test, and multivariate Cox models. Results: The processing rate for PMAS was 1.7-fold to 5.5-fold faster than MA, after adjusting for potential confounding variables. Discussion: The implementation of the PMAS reduced the processing time of ESLs, which benefits the workers affiliated to the public insurance system in Chile. ; Introducción: El retraso del procesamiento de las licencias médicas (LMs) representa un problema de salud pública en Chile, considerando que esto afecta el pago del subsidio a las personas destinado a realizar el reposo médico prescrito mientras no se pueda trabajar. El objetivo de este estudio fue explorar las diferencias en el tiempo de procesamiento de las licencias médicas electrónicas (LMEs) evaluadas por contraloría médica (CM) y las evaluadas por un sistema predictivo de contraloría médica (SPCM) basado en redes neuronales artificiales. Materiales y métodos: El tiempo de procesamiento de LMEs procesadas con SPCM fue comparado con el tiempo de procesamiento de LMEs examinadas solo con CM, usando curvas de Kaplan Meier, prueba de log-rank y modelos multivariados de Cox. Resultados: La tasa de procesamiento del SPCM fue entre 1,7 a 5,5 veces más rápida que la tasa de procesamiento de la CM, ajustando por potenciales confusores. Discusión: La implementación del SPCM permitió disminuir el tiempo de procesamiento de las ...

This study examines the status of Medical Audit in law enforcement in the medical field, and to what extend can Medical Audit be used as evidence in court proceedings. The concept of this research is juridical-empirical, with descriptive-qualitative study, the method used is literature and interviews, relying on legislation relating to health services in hospitals. This study uses a theory consisting of health legal instruments relating to ethics and law, Hospital Law, Medical Records, Medical Audits, Professional Standards, and Operational Procedure Standards, as well as materials for criminal actions and criminal accountability. The results showed that Medical Audit can be applied in investigations and inquisitions by the police. However, the police do not use Medical Audit as an instrument of enforcement and verification, whilst it is very crucial in assessing a certain relevant issue. Law enforcement is expected to be able to make the Medical Audit as part of the admissible evidence in the Police.