High quality at low cost—how can a clinical pathway contribute towards reconciling this apparent contradiction?

Abstract

–The cost-intensive care of a growing number of pain patients means that hospitals specialising in interdisciplinary pain therapies as part of providing acute inpatient care are placed under increasing pressure in ensuring that the quality of care remains high while the costs incurred remain low. The purpose of the present study is to investigate whether a clinical pathway for multimode pain therapy in diseases and disturbances of the musculoskeletal system and connective tissue remains the quality of care high while the costs incurred remain low. Analysis is necessary of the core processes of pain therapy in respect of quality and costs, taking account of the ages and comorbidities of the two groups of subjects. This analysis examines the pain intensity, the costs incurred for the care personnel, therapy minutes involved, and hospitalisation duration. It`s shown that costs can be lowered as a result of the CP and that, despite a reduction in the duration of hospitalisation, the pain intensity on being discharged from hospital is no lower than for the comparison group without CP. A clinical pathway, referred to indications, should be developed by all personnel involved in the therapy process and, in the medium term, should become a fixed component of operative and strategic business management. Keywords––clinical pathway, DRG, pain therapy, personnel costs of the nursing service, quality, pain intensity, duration of hospitalisation, secondary diagnoses, therapy minutes.