Professional Standards Review Organization and pedodontics: a status report.

The Professional Standards Review Organization is a Federal quality assurance program for Medicaid, Medicare, and Crippled Children’s Programs health services which was legislated in the early 1970s in response to administrative, economic, social, and professional concerns. The program is now fully implemented and provides local review of hospital admissions, including pedodontic admissions, through the mechanisms of concurrent review, medical care evaluation studies, and profiles. Extension to review ambulatory services, including dental services, is authorized by legislation. Dentists are precldded from membership. The future interaction between pedodontists and the PSRO is expected to increase as Federal health care programs and quality assurance programs expand. Peer review, quality assessment, Medicaid "abuse," and third party review are topics of immediate interest to clinicians and health planners alike. Federal and state administrators, insurance carriers, and dental organization officials are involved in defining workable and appropriate methods of review. While this process will continue over the coming years, it is important to note that the dental practitioner is already subiect to review through both private and public programs. One of the most far-reaching and institutionalized review mechanisms is the Professional Standards Review Organization (PSRO). The PSRO is a specific legal entity currently in opAccepted September 14, 1979 eration throughout the United States which directly affects the professional activities of all hospital-affiliated dentists including many pedodontists who admit patients to hospitals. Since the PSRO’s impact on dentistry is marginal at present, many practitioners disregard its existence or fail to become fully informed of its authority. However, the enabling legislation and ongoing governmental interest in services for children suggest that dentists will increasingly be affected by PSRO activities. This paper briefly reviews the history and functions of the PSRO and identifies the current and proiected relationship between PSRO and pedodontics.