Assessing the efficacy of a clinical pathway in the management of older patients hospitalized with congestive heart failure.
Congestive heart failure (CHF) is the most common cause for hospitalization in older patients, and the prevalence of this condition is expected to rise as the population ages. The high cost of care has resulted in an increased emphasis on cost-effective approaches in patient management. One way to achieve this is the use of clinical pathways. This article compares outcomes in a group of older hospitalized patients managed on a CHF pathway with those of a historical cohort managed in the traditional manner. The patients on the pathway had significant reductions in length of stay and cost of care as well as more effective delivery of processes of care. Mortality rates were unchanged, at 3.5%. However, readmission rates showed a significant increase, from 9.25% to 13.5%, for patients on the pathway.
Cardozo
L
L
Wayne State University School of Medicine, USA.
Aherns
S
S
D000368:Aged; D015331:Cohort Studies; D017046:Cost Savings; D003362:Cost-Benefit Analysis; D019091:Critical Pathways / Q000592:standards*; D004496:Education, Continuing; D005260:Female; D006302:Health Services Research / Q000379:methods; D006333:Heart Failure / Q000191:economics / Q000628:therapy*; D006760:Hospitalization / Q000191:economics* / Q000706:statistics & numerical data; D006801:Humans; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D008824:Michigan; D010043:Outcome and Process Assessment, Health Care; D010359:Patient Readmission