Team Members and Patients’ Views on Cost-effectiveness of (Integrated) Clinical Pathway

Abstract

BACKGROUND: Integrated clinical pathways (ICPs), which have particularly enhanced existing clinical pathways (CPs) through the work of multifunctional teams, have become an important tool to enable informed decision-making and provide more efficient, cost-effective, and value-based care. AIM: In the absence of studies on the cost-effectiveness of ICPs, the aim of this study was to determine the opinion of team members treating patients with total hip arthroplasty and their patients on the practice of cost-effectiveness of the existing CP and ICP that might be introduced in the future. METHODS: A mixed descriptive quantitative and qualitative approach was used. A survey of 61 team members of CP for total hip arthroplasty was conducted, as well as in-depth interviews (n = 12) and focus groups (n = 11). In addition, in-depth interviews were performed with 20 patients who had undergone total hip arthroplasty at CP in a typical Slovenian general hospital. RESULTS: The results showed that participants occasionally prioritized cost-effectiveness over quality of health care. They frequently used CP to reduce the cost and time of patient care. Nurses with secondary education were statistically significantly more likely to prioritize cost-effectiveness of health care over quality of health care than nurses with higher education, physicians, and others. Team members and patients evaluated positively the cost-effectiveness of ICP for total hip arthroplasty, but patients also pointed out that staff, especially nurse had too little contact with patients. CONCLUSION: Both team members treating patients with total hip arthroplasty and their patients have a positive attitude toward the cost-effectiveness of ICP. The nursing staff has too little contact with the patients due to staff shortages.