Analysis of Clinical Pathway on Impacting Length of Stay and Hospitalization Expenses for Five Diseases

Abstract

Objectives. To analyze related indicators of five diseases before and after the implementation of clinical pathway (CP) in a Class-A tertiary hospital, to assess the status and effect of implementation of CP in this hospital, and to provide a certain practical basis for the implementation and promotion of the CP in medical institutions. Methods. We mainly selected five diseases characterized by a large number of inpatients, definitive diagnosis, effective treatment, and small differences in operation or treatment. We chose the cases with the CP implementation from June 2011 to December 2012 as a pathway group and the corresponding cases without the CP implementation from June 2009 to December 2010 as a control group by utilizing the electronic medical record (EMR) system of the hospital information department, through a retrospective survey. We compared and analyzed the hospitalization expenses, medicine expenses, length of stay (LOS), and other conditions of the two groups of cases statistically. Results. The average LOS and medicine expense of the patients with inguinal hernia, senile cataracts, premature rupture of membranes, varicose veins and vocal cord polyp, after implementing the CP in the pathway group, were less than those in the control group, so that the differences have statistical significance (P < 0.05); the average hospitalization expense and medicine expense of the patients with inguinal hernia, senile cataracts and premature rupture, after implementing the CP in the pathway group, were lower than those in the control group, so that the differences have statistical significance (P < 0.05). However, the average hospitalization expense and medicine expense of the patients with vocal cord polyp after implementing the CP in the pathway group were higher than those in the control group, thus differences have statistical significance (P < 0.05). The differences have no statistical significance in the comparison of the average hospitalization expense and medicine expense for patients with varicose veins, in the pathway group and the control group (P > 0.05). Conclusions. The administration of the CP of five diseases in the hospital can shorten the average LOS of patients, reduce the medical costs, improve the bed turnover rate, and promote the effective use of hospital resources. The CP implementation for some diseases greatly reduced the average hospitalization expenses and medicine expenses of patients, and reduced the unreasonable use of medicines, thereby relieving the economic burden of the patients. However, there were no effects of CP implementation for some diseases, even the average hospitalization expenses and medicines expenses were increased.